|Date Posted||November 8, 2019|
Under the supervision of the AVP of Compliance, the Regulatory Compliance & Privacy analyst will manage, develop, implement and monitor policies, procedures, processes, training, corrective action plans and overall operations to ensure compliance with federal and state laws and regulations affecting the Company. The Analyst will work collectively with management and other personnel to ensure that compliance initiatives are implemented.
Essential Job Functions
Responsible for leading efforts implementing, monitoring and tracking Compliance Program elements and providing direction and guidance to personnel for adherence to industry regulations, system policies, Federal Sentencing Guidelines, CMS Conditions of Participation, CHAP Accreditation, Conditions of Payment and State specific requirements.
Manages all aspects in one or more subject-matter areas of Compliance operations and works directly with Compliance Directors to implement specific components of the annual Compliance Plan
Performs or assist with overseeing initial, periodic and annual regulatory compliance and privacy risk assessment/analysis, mitigation, and remediation.
Manages validation of Compliance Program Metrics, identifies gaps and develops and reports aggregated data by Affiliate. Develops management and committee reports based on aggregated System data.
Collects documentation from Compliance Directors quarterly and annually regarding their Compliance Program Metrics and assists in determining documentation is appropriate, reviews for statistical accuracy, meets standards, requests more information if required, and ensures it is complete.
Works collaboratively with the Compliance Officers in understanding and continually monitoring the metrics, identifying educational gaps and develops process and training tools to close those gaps.
Validates data as requested and makes recommendations to improve the accuracy of the data. Presents ideas for modifications and additions to the metrics to make the Compliance Program more robust or measure compliance outcomes.
Prepares corporate compliance summaries into electronic formats for meetings and presentations.
Previous Healthcare/Home Health industry experience.
Substantial knowledge of health care fraud and abuse laws and regulations, including the Anti-Kickback Statute.
Strong analytic, problem solving and process improvement skills.
Excellent communication skills, both written and oral.
Ability to manage several matters at one time, in a fast-paced environment.
Organized, timely, efficient, versatile, able to work independently, able to prioritize, and detail oriented.
High degree of maturity and professionalism.
Working knowledge of Microsoft Word, Outlook, PowerPoint and Excel.
One to three years of legal/compliance experience.
CHC, CHPC, or equivalent preferred, within one-year of hire.
Experience with data analysis tools and techniques are preferred.
Two (2) or more years of experience in a business, professional or health care environment, including one (1) year experience in a Compliance, Internal Audit, Billing, Coding, Education and Training, Case Investigations, Research or equivalent related fields is required.
Must be able to adhere to confidentiality standards and professional boundaries at all times
Quick-thinking and astute decision making skills
Attention to detail
Effective problem-solving and conflict resolution
Excellent organization and communication skills
Ability to remain calm and professional in stressful situations
Strong commitment to excellence
Must be able to speak, write, read and understand English
Occasional lifting, carrying, pushing and pulling of 25 pounds
Prolonged sitting, walking, standing, bending, kneeling, reaching, twisting
Must be able to sit and climb stairs
Must have visual and hearing acuity
Performs duties in an office environment during agency operating hours
Must be able to function in a wide variety of environments which may involve exposure to allergens and other various conditions
Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.
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