• Compliance and Risk Management, Sr. Manager

    Job Locations US-CA-Hayward
    Job ID
    2018-1228
    Location Site
    HAYWARD -HWD
    Category
    Administration
    Type
    Regular Full-Time
  • Overview

    As the operational lead in charge of TVHC’s compliance and risk management programs, this position works under the supervision and guidance of the Executive Vice President/Chief Administrative Officer (EVP/CAO). The Sr. Manager, Compliance and Risk Management, develops and oversees a system for uniform handling of violations in Standards of Care, regulations, policies, protocols and procedures, by conducting root-cause analysis and following notice requirements where applicable. Specifically the position is responsible for risk assessment and management in areas of key performance for key departments, measuring against established standards for quality and compliance, providing timely and efficient reporting to management and parties accountable within the organization.

     

    This role will have significant responsibility for TVHC’s pursuit of organizational and strategic improvements as it impacts compliance matters, risk management and patient and staff safety. The individual works closely with the EVP/CAO, and Human Resources Director to measure through data collection and analysis, workflow assessment, development and implementation of enhanced protocols or procedures affecting the way TVHC staff perform their respective job duties. The Sr. Manager, Compliance and Risk Management serves as a channel of communication to receive compliance and risk management issues to appropriate resources for investigation and resolution. In addition, he/she will be an internal resource with which concerned parties may communicate after other formal channels and resources have been exhausted.

     

    The individual in this role must command knowledge in FQHC standards of practice, as well as other legal and ethical codes and regulations applicable to FQHCs and health care organizations.

     

    Benefits:

    • Monday through Friday (8-5pm hours)
    • 100% employee only medical coverage (includes paid co-payments, prescriptions and premiums).
    • Spouse and dependent coverage also available. 
    • Dental, vision (spouse and dependent coverage available)
    • Generous PTO
    • 14 holidays
    • Flexible Spending Accounts
    • 403(b) retirement savings plan

    Responsibilities

    • Manages day-to-day operations of the Compliance and Risk Management department including directly supervising Compliance and Risk Management Department staff.
    • Leads and supports ongoing development, refinement, implementation, measurement, ongoing improvement and effectiveness of TVHC’s Compliance and Risk Management Plan.
    • Documents and provides regular reporting to the CAO/EVP and Board of Directors (BOD) on the status of Compliance and Risk Management Program.
    • Develops and implements a written plan that describes the Compliance and Risk Management Program. Writes, implements, maintains, and revises policies and procedures for the general operation of the Compliance Program and its related activities to prevent illegal, unethical or improper conduct.       Reviews other organizational policies.
    • Plans, coordinates, and provides guidance for the integrated functions of organizational strategic and risk management assessment and improvement, patient and staff safety. Utilizes project management methodologies, supporting the development and implementation of compliance assessment/process improvement and redesign. Leads and participates on teams that identify the best known compliance and operational practices to achieve and retain optimal outcomes.
    • Provides technical information in an equitable and consistent manner for staff, management, and Board of Directors concerning practice regulations, laws and standards, along with other related matters; provides guidance, direction, and training, as applicable, or makes recommendations for effective correction of performance issues from a corporate compliance stand point.
    • Responds to alleged violations of rules, regulations, policies, procedures, and Standards of Conduct by evaluating or recommending the initiation of investigative procedures. Conduct investigative action and correction initiatives for all compliance issues. Follows through with all investigative procedures to resolution of the final outcome, developing and overseeing a system for uniform handling of such violations. Ensures proper reporting of violations or potential violations to duly authorized enforcement agencies as appropriate and/or required.
    • Institutes and maintains an effective compliance communication program for the organization, including promoting (a) use of the Compliance Hotline (EARS); (b) heightened awareness of Standards of Conduct and HIPAA rules, and (c) understanding of new and existing compliance issues and related policies and procedures. Oversees compliance with, and completes application for the FTCA redeeming process and program requirements.
    • Assists the CAO with monthly meetings, collaborates with management and staff to identify and support implementation of quality and compliance monitoring, and review audits as required by Health Resources and Services Agency (HRSA) and other regulatory agencies.
    • Oversees policy distribution to operational owners and revision tracking, including compilation of a monthly Board report of policies to be approved. Create and send a quarterly summary of all approved policies to “All Staff.” This person will also be responsible for assuring maintenance of compliance and risk management intranet resources.
    • Works with the Operations Department on Emergency Preparedness.
    • Works with the Human Resources Department and others as appropriate to develop an effective compliance training program, including appropriate introductory training for new employees as well as ongoing training for all employees and managers. May participate as consultant for employee disciplinary matters involving policy violations as needed.
    • Performs all duties in accordance with TVHC’s Service Excellence Standards.
    • Assumes other duties, including special projects, as assigned or needed.

    Qualifications

    • Bachelor’s degree in public health, business management nursing, legal studies or related field, or equivalent, required.       Master’s in, public health, business management, related field, or equivalent, highly preferred.
    • Minimum of three to five years of experience working directly with corporate compliance and/or in a healthcare setting in a lead or supervisory capacity.
    • Must have extensive knowledge and understanding of standards and relevant legislation, laws, regulations, precedents and protocol of clinical practice for FQHCs. Knowledge of comparative databases and reporting requirements, EHR systems strongly preferred.
    • Familiarity with operational, financial, clinical quality measurement and general personnel procedures and regulations required.
    • Certified in Healthcare Compliance (CHC) a significant plus.

     

    Education and Experience:

     

    • Capacity to work at a fast pace with multiple priorities and deadlines.
    • Superior interpersonal skills. Able to work well with all levels of diverse work force.
    • Superior communication skills, both written and verbal.
    • Proven command of clinical operations standards, including a clear understanding of practice

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