Compliance Specialist III

CHSGa

– a place where you’ll be valued, recognized and rewarded for the vital work you do each day. We’ll surround you with a strong team and leadership that supports every aspect of your life – both inside and outside of our centers. And you’ll get to practice your passion  in a non-profit, mission-driven organization that’s known for the highest level of care in our communities

ESSENTIAL DUTIES AND RESPONSIBILITIES

• Lead in the implementation of a Compliance Program that promotes prevention, detection, and resolution of instances of conduct that do not conform to federal and state laws, federal, state and private payor healthcare program requirements, as well as the organization’s policies / guidelines.
• Establish and maintain compliance plans based on identified risks to promote program effectiveness for assigned areas.
• Identify compliance issues that require follow-up or investigation, providing guidance on resolution strategies and escalating to leadership as appropriate.
• Create and maintain accurate and up-to-date documentation of compliance activities, including risk assessments, work plans, procedural guidelines, review findings, and investigation outcomes, ensuring they are readily accessible and align with regulatory requirements.
• Coordinate and lead Compliance Committee meetings for designated service areas.
• Lead the design and development of compliance training programs, including introductory training for new associates and ongoing training for associates and supervisors.
• Lead reporting, monitoring, and auditing activities as assigned, providing timely reporting of compliance issues to leadership.
• Functions as an advanced user of the compliance software database, including guideline maintenance and compliance reporting.
• Coordinate and lead internal or external audit processes, including relevant analysis, documentation and follow-through on findings and corrective actions. Respond to complex verbal and written inquiries, providing thorough and accurate compliance guidance.
• Collaborates with other departments (i.e. Finance, Human Resources, Operations, IT/IS, QA, etc.) to direct compliance issues to appropriate existing channels for investigation and resolution.
• Coordinate and oversee the policy / guideline governance process for assigned areas.
• Assists with the development of compliance internal practices in conjunction with the compliance team.
• Identifies opportunities for system consistency and risk mitigation related to compliance and provides recommendations to leadership.
• Serves as a mentor to junior Compliance Team members, promoting professional growth and advancement in compliance matters.
• Supports special projects designed to promote compliance efforts across System areas.
• Maintain knowledge of relevant laws, regulations and recommended practices via individual study, monitoring, and participation in workshops and seminars.
• Promotes the image and reputation of the System by exhibiting servant leadership and providing direct and open lines of communication.
• Contributes to the work of committees, workgroups, project management, and other collaborative efforts of the System.
• Performs other duties as necessary to ensure the success of the System.

SKILLS AND ABILITIES

• Demonstrates leadership and excellent communication skills.
• Strong planning, time management, and organizational skills.
• Demonstrates sound judgment and the ability to effectively communicate and present information clearly and concisely in both written and verbal formats.
• Strong working knowledge of the healthcare industry, including HIPAA and regulations governing health information management, post-acute care services, and compliance laws, rules and regulations governing patient care and related services.

MINIMUM QUALIFICATIONS

• Bachelor’s degree in business administration, healthcare management, or a related field; Master’s degree preferred.
• 5 - 7 years of experience in compliance, risk management, internal audit, or a related area, with at least three (3) years within the area of healthcare compliance. Certified in Healthcare Compliance (CHC) preferred. 

SUPERVISORY RESPONSIBILITIES

• None

LANGUAGE SKILLS

Ability to read and interpret documents such as safety rules, operating and maintenance instructions and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively before groups of customers or associates of the organization.

MATHEMATICAL SKILLS

Ability to add, subtract, multiply and divide in all units of measure, using whole numbers, common fractions, and decimals.

REASONING ABILITY

Ability to apply common sense understanding to carry out instructions furnished in written, oral or diagram format. The ability to deal with problems involving several concrete variables in standardized situations.

COMPUTER APPLICATION SKILLS

This job requires proficiency with the following computer applications:

Microsoft Outlook      Microsoft Excel      Microsoft Word      Microsoft PowerPoint  

Additionally, a wide variety of specialized software may be used to fulfill requests.

PHYSICAL DEMANDS

The physical demands described here are representative of those that must be met by an associate to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the associate is regularly required to sit, talk or hear. The associate frequently is required to walk. Use hands to finger, handle or feel and reach with hands and arms.  Lifting, that may be repetitive, of up to 30 lbs.  The associate is occasionally required to stand. Specific vision abilities required by this job include close vision, distance vision and the ability to adjust focus. 

WORK ENVIRONMENT

The work environment characteristics described here are representative of those an associate encounters while performing the essential functions of this job. Works in home/remote office with frequent assignments at the main office location, as well as throughout nursing center locations and their premises.  Moves intermittently during working hours.  Travel is required up to 50% of the time.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

The noise level in the work environment is usually quiet.

EEO / M / F / D / V / Drug Free Workplace