Specialist, Compliance

KePRO - Nashville, TN3.0

Full-time
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Job Details
Description
KEPRO is a rapidly growing national quality improvement and care management organization. We work to ensure that over 20 million people receive the right care, at the right time, in the right setting. KEPRO is seeking resumes for a highly experienced professional

Specialist, Compliance

Summary Description

The Compliance Specialist oversees the local Compliance Program, functioning as an independent and objective body that reviews and evaluates compliance issues/concerns within the local site. This includes reviewing, planning, and implementing initiatives related to compliance, as well as, auditing, monitoring and evaluating the effectiveness of compliance with the contract, laws, and regulations of governing bodies and accrediting agencies. This position will also serve as the Privacy Officer.

Accountabilities

Govern system performance, including integration of the Business Process Compliance (BPC) program activities into all program operations to ensure program compliance, improve management and performance, and reduce risk and areas of vulnerability, specifically for maintaining policies and procedures and overall improvement efforts related to the staff performance, systems functioning, and business processes.
Serve as the site’s Privacy Officer - Develop and implement policies, procedures and practices according to the HIPAA Privacy and Security Rules, receiving privacy and security-related complaints and providing further information about privacy and security-related matters to the State and Contractor's staff, as needed.
Collaborate with all operations to direct compliance issues to appropriate existing channels for investigation and resolution. Consult with legal counsel as needed to resolve difficult compliance issues.
Document, track, investigate, and respond to confidentiality breaches, requests, complaints and appeals concerning privacy policies and procedures. Oversee a system for uniform handling of such violations.
Identify potential areas of compliance/privacy vulnerability and risk; develop/implement corrective action plans for resolution of problematic issues, and provide general guidance on how to avoid or deal with similar situations in the future.
Monitor and periodically audit operations to test the completion and effectiveness of compliance with internal policies and procedures, and with Federal, state, and local laws, regulations and rules; benchmark the program’s effectiveness.
Assist in implementing, coordinating and evaluating compliance program and Health Insurance Portability Accountability Act (HIPAA) compliance activities. Assist staff with the use and disclosure of protected health information (PHI) and ensure compliance with privacy policies, procedures, and legal requirements.
Provide reports on a regular basis, and as directed or requested, to keep the Quality Management Committee informed of the operation and progress of compliance efforts.
Assist Human Resources and designated operational staff/management to develop compliance/privacy training programs, including appropriate introductory training for new employees as well as ongoing training for all employees and management.
The list of accountabilities are not intended to be all-inclusive and may be expanded to include other duties that management may deem necessary from time to time

Qualifications

Minimum Associate’s degree required, Bachelor’s degree strongly preferred in health-related field, business administration, or pre-law that provided a broad educational background for the diverse responsibilities for this position.
Knowledge, Skills, Abilities

Ability to maintain and update documentation of business processes as they evolve; track all stages of approval.
Maintain work in an organized and accessible fashion.
Research and investigate root causes of underperforming compliance areas to make recommendations for improvement.
Identify and resolves problems in a timely manner, gather and analyze information skillfully; work well in-group problem solving situations.
Evaluate information against a set of standards.
Synthesize information into clear and concise reports and training modules.
Proficient in Microsoft Office programs.
Experience

Minimum one year of experience with corporate compliance, that included staff training, developing policies/procedures, compliance reviews and investigations, monitoring and audits, contract compliance
Mental and Physical Requirements

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations will be made as required by law in an attempt to enable an individual with a disability to perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to sit for prolonged periods of time; key and/or control objects; interact extensively with internal and external customers; occasionally lift and/or move objects weighing up to 10 pounds; and occasionally travel within the state.

KEPRO offers challenging careers, excellent benefits and opportunities for advancement. For consideration, please submit resume and cover letter with salary requirements. Only those candidates identified for an interview will be contacted. No Phone Calls Please. Visit our website at www.KEPRO.com for more information on the KEPRO Family of Companies.

EOE AA M/F/Vet/Disability

KEPRO is an E-Verify employer. E-Verify is an internet based system operated by the Department of Homeland Security (DHS) in partnership with the Social Security Administration (SSA) that allows participating employers to electronically verify the employment eligibility of their newly hired employees in the United States.

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information.