Job Description
Compliance and Privacy Officer The candidate will implement and oversee the compliance and HIPAA privacy program for Group and identify, prevent, and detect regulatory and compliance issues. Serve as the focal point for compliance and privacy activities for Group and shall have direct access to the Group Board of Directors and the Executive Director. Report directly to the Executive Director of Group and indirectly to the Chief Compliance Officer of the Hospital. Responsible for development and ongoing review of Group compliance standards and policies, and distribution to all affected employees and management. Oversee and monitor the effectiveness of Group's compliance program. Monitor current government enforcement initiatives and developments/ changes in relevant state and federal laws and regulations, government agency guidance, court rulings and payor policies and procedures to: (1) coordinate with internal audit in evaluating risk and developing plans for correction and continual monitoring; and (2) determine whether the compliance program should be modified to address any identified risk areas. Develop, coordinate and participate in a comprehensive education and training program that focuses on the elements of Group's compliance program and that seeks to ensure that all appropriate employees and management are knowledgeable of, and comply with, pertinent federal, state and private payor standards. Develop and oversee Group policies and programs that encourage managers and employees to seek clarification of Group policies, discuss compliance questions and concerns, and report suspected fraud and other improprieties without fear of retaliation. Ensure that the HHS-OIG's List of Excluded Individuals and Entities, and the General Services Administration's List of Parties Debarred From Federal Programs, have been checked with respect to all employees and independent contractors. Develop and maintain a monitoring and auditing process to ensure that the compliance program is functioning effectively. Report regularly to the Board or a designated Committee of the Board. Such reporting will include data on the status of Recovery Audit Contractor (RAC) audits. Develop, implement and publicize a uniform employee disciplinary procedure. Develop and implement a process for investigating and acting on any report or allegation concerning possible unethical or improper business practices, and monitor subsequent corrective action and/or compliance. Review all documents and other information that are relevant to group's compliance activities, including contracts and obligations that may contain referral and payment issues that could violate the anti-kickback statute, as well as the physician self-referral prohibition and other legal or regulatory requirements. Perform other related duties deemed necessary by the Executive Director of Group.
