The Chief Compliance and Privacy Officer implements an effective compliance program promoting the highest standards for supporting caregivers and their families on behalf of government and managed care organizations while providing expertise, consultation, and assessments in matters related to compliance, audit, and risk. S/he provides leadership and oversight of Seniorlinks compliance and privacy programs, including leading continuous improvement activities. This individual works collaboratively with departmental leadership to ensure that all employees understand and are in compliance with relevant state and federal regulations, contractual requirements, Seniorlinks Code of Conduct and related policies and procedures. S/he monitors and reports compliance and privacy efforts as well as company results to the CEO, Board, and senior management teams. This individual also serves as key contact with external oversight agencies and auditors and is the primary point of contact with such agencies and individuals.
What You Will Do:
Oversight for the development and implementation of Seniorlinks Compliance and Privacy Programs including development and implementation of a Compliance Plan, monitoring, reporting, and continuous improvement.
Oversight for the regular auditing of business processes to ensure compliance with policies, regulations, contracts, procedures and laws; serve as primary contact for external audits, including federal and state audits.
Act as an independent reviewer to ensure that compliance issues and concerns within the organization are being appropriately evaluated, investigated and resolved. Monitors for related trends and develops and leads implementation of interventions to mitigate risks.
Receive and respond to reports or allegations of unethical or improper conduct or business practices, including by conducting investigations independently or in coordination with qualified legal counsel, or by delegating the responsibility for conducting an investigation to other staff, and implement and monitor appropriate corrective action and subsequent compliance.
Report information on the activities of the Compliance Program to the Compliance Integrity Committee of the Board of Directors on a quarterly basis. Co-facilitate Quality, Integrity, and Compliance Committee meeting with Seniorlink executive staff on a quarterly basis.
Oversight for the development and annual review of policies relating to corporate compliance; stays current on changes in federal and state policy as well as emerging trends in the regulatory market and provides strategic direction to the leadership team.
Manage all caregiver, consumer, and employee complaints concerning privacy and policy breaches as well as cases of suspected fraud and abuse; includes tracking, investigation, response, and reporting; develops and oversees a system for uniform handling.
Provide management of internal and external compliance hotlines.
Develop, coordinate, and lead a training program, updated annually, that focuses on the components of the Compliance program and seeks to ensure that all individuals (e.g. Board members, employees, caregivers) are knowledgeable of, and comply with, pertinent standards and Seniorlinks Compliance Program including adherence to the code of conduct
Identify potential areas of compliance risk, develop and implement corrective action plans; provide guidance on how to mitigate or avoid future risk.
Serve as the HIPAA Privacy Officer including oversight for the establishment, implementation and adherence to policies on consumer privacy, confidentiality and release of information.
May draft and review a wide range of agreements including contracts, business associate agreements, license agreements, consulting agreements, service agreements, engagement letters, and non-disclosure agreements.
What You Will Bring:
Bachelors degree required; Juris Doctor strongly desired; Certifications in healthcare compliance and privacy preferred
10 years of compliance experience in a healthcare environment; 5 years of privacy related experience in a healthcare setting.
Working knowledge of governmental, Medicaid, and Medicare regulations and healthcare reporting requirements; experience in information privacy laws.
Strong leadership skills and understanding of how to ensure an effective compliance plan is distributed throughout all levels of the organization.
Excellent critical thinking and influencing skills across all organizational levels.
Ability to manage conflict effectively while showing receptivity to the ideas and concerns of others.
Experience drafting and reviewing legal agreements and contracts strongly desired.
To apply for this job email your details to firstname.lastname@example.org