The Compliance Specialist is a key associate at Hope Network whose primary responsibilities include:
The Compliance Specialist coordinates corporate compliance systems, reporting and investigations for Hope Network and its subsidiary corporations under the direction of the Corporate Compliance Officer. The Specialist monitors and audits compliance tools and processes designed to ensure compliance with applicable laws and accreditation standards. The Specialist is also responsible for evaluation of information tracking systems to ensure integrity of the compliance systems and monitoring of applicable regulations and laws as assigned. Additionally, the Specialist serves as a network HIPAA Privacy and Security consultant; he or she will provide compliance related staff training and assist with the ongoing technical development and evaluation needs of Hope Network and its Compliance Program.
ESSENTIAL FUNCTIONS AND RESPONSIBILITIES:
This is not intended to be an exhaustive listing of job functions. This job description is in no way states or implies that these are the only duties to be performed by this employee. The employee is required to follow any other instructions and to perform any other duties as assigned by management.
1. Regular and predictable attendance is an essential requirement of this position.
2. Analyze and aggregate compliance and safety data from corporate subsidiaries assisting in identification and development of data sources, development of enterprise wide Compliance reporting, consistency in data collection and integrity of data.
3. Assists in the development and implementation of compliance monitoring programs and procedures and conducts or coordinates such monitoring as is necessary to ensure compliance with external regulations and related internal controls. Recommends internal control structure and process changes to avoid reoccurrence. Gathers and assists in disseminating legal and regulatory changes to help ensure timely internal adoption.
4. Assists Corporate Compliance Officer and subsidiary corporation compliance staff with ongoing review of corporate policies and procedures, coordinates changes to policies and procedures to ensure they meet the ongoing needs of Hope Network and regulatory requirements.
5. Assists with monitoring internal controls and communication avenues (compliance hotline, written correspondence, emails, and phone calls). Responds as appropriate, keeps logs, maintains systems and prepares reports.
6. Coordinates with compliance staff of subsidiary companies to monitor incident reports, contribute to trend analysis, and develop corrective action plans and required reports.
7. Assists in the development and implementation of compliance risk assessment processes and programs, and in conducting annual and periodic compliance risk assessments. Assists in the implementation and monitoring of corrective actions following the risk assessments.
8. Partners with Talent Management to coordinate required training. Assists in preparing training materials, scheduling, tracking attendance, following up a required and maintaining files of training seminar materials and training meetings.
9. Assists subsidiary corporation Compliance staffas necessary to ensure compliance with service contracts, as well as CARF surveys and accreditation.
10. Manage Corporate Compliance Calendar
11. Serves on various committees and task forces related to compliance and risk management.
Educational / Talent Requirements:
1. Associate degree in related field (Bachelor’s Degree preferred). Minimum of three (3) years’ experience preferred. Five (5) years of relevant experience may be substituted for a degree.
Work Experience Requirements:
1. Demonstrated ability to communicate in both written and verbal format to meet position responsibilities.
2. Demonstrated ability in analysis, evaluation and research of complex compliance issues. Attention to detail and ability to prioritize essential.
3. Ability to adhere to and uphold Hope Network’s Code of Ethics and exercise good judgment and maintain the confidentiality of critical and sensitive information, records and reports.
4. Expertise with Microsoft Office, Windows based applications, office systems, procedures and equipment.
5. Demonstrated ability to work effectively with broad range of staff.
6. Substantive knowledge of HIPAA and Medicare/Medicaid billing regulations. Understanding of their application in the area of developmental disability and mental health setting desired. Previous managed care experience preferred.
7. Ability to articulate and actively support the mission of the corporation to various audiences.