• Compliance and Risk Management Specialist

    Job Locations US-CA-Hayward
    Job ID
    2018-1288
    Location Site
    HAYWARD -HWD
    Category
    Administration
    Type
    Regular Full-Time
  • Overview

    As one of the key members in the Compliance and Risk Management Department, this position works under the supervision and guidance of the Chief Administrative Officer. The Compliance and Risk Management Specialist handles violations in Standards of Care, regulations, protocols, policies and procedures, and conducts risk assessment analysis across the organization to establish standards for quality and compliance. This position will also provide substantial support in on-going investigations of significant events that occur in the organization and will help to create appropriate resolutions to address the situation. In addition, this role will assist in providing timely and efficient reporting to management and parties accountable within the organization. This position works closely with the EVP/CAO, Sr. Manager of Compliance and Risk Management and Human Resources Department, to measure workflow assessment, develop and implement enhanced protocols and procedures affecting the way TVHC staff perform their respective job duties.

     

    Tiburcio Vasquez Health Center, Inc. is a non-profit community health center that is dedicated to promoting the health and well-being of our community by providing accessible, high quality care by integrating primary care, dental care, WIC support, mental health counseling, community health education and more.

     

    Benefits:

    • 100% employee only medical coverage (includes paid co-payments, prescriptions and premiums)
    • Spouse and dependent coverage also available
    • 15 days of PTO
    • 14 paid holidays
    • Flexible Spending Accounts
    • 403(b) retirement savings plan

    Responsibilities

    • Under the direction of the Chief Administrative Officer, works collaboratively with other departments as appropriate to coordinate compliance mock audits, develops audit reports and corrective action plans. Develops and coordinates with other departments appropriate compliance training programs for staff.
    • Assists Chief Administrative Officer in providing input and representation on key compliance and quality initiatives, meetings and committees. Stays abreast of industry and compliance trends; recommends and implements changes to internal agency processes as needed.
    • Responsible for maintaining compliance and risk management documents, case files and correspondence in an organized, confidential and secure manner. Compiles, monitors and reports data related to risk management. Conducts routine reporting for external agencies.
    • Supports ongoing development, refinement, implementation, measurement, ongoing improvement and effectiveness of TVHC’s Compliance and Risk Management Plan.
    • Works in conjunction with the Operations Department on Emergency Preparedness to develop and implement the Emergency Operations Plans organization-wide. This includes developing corrective action plans and implementing safety plans to improve overall patient and staff safety. Also coordinates annual safety drills to meet external agency requirements (e.g. CMS).
    • Responds to alleged violations of rules, regulations, policies and procedures 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 reporting of violations or potential violations to duly authorized enforcement agencies as appropriate and/or required. Investigates matters related to patient complaints and incidents, including conducting internal investigations (e.g. responding to patient experience of care reports or incident reports.)
    • Provides technical expertise in health data collection, analysis, monitoring, maintenance, and reporting activities in accordance with established data quality principles, legal and regulatory standards, and professional best practice guidelines. These functions encompass, among other areas, processing and using health data for coding, billing, compliance, and surveillance purposes; performs these functions through the use of various electronic systems.
    • Works collaboratively with other departments, such information technology (IT) as well as external community stakeholders on strategies to improve data collection and outcomes measurement, comparing these to County, State, and Federal results and develop customized reports to extract and collect data related to quality control practices according to client or management needs.
    • Ensures that information and reports produced are compliant with HIPAA and all other applicable regulations regarding security and patient privacy.

     

    Engages in the Development and Implementation of Training Programs

    • In conjunction with the Chief Administrative Officer, develops, coordinates, and participates in a multi-faceted education and training program that focuses on the elements of the compliance program, and seeks to ensure that all appropriate employees and management are knowledgeable of, and comply with, pertinent federal, state and county standards
    • Works with other departments as appropriate to develop an effective compliance training programs, including appropriate introductory training for new employees as well as ongoing training for all employees and managers.
    • Collaborates with management team and staff to identify, review and implement quality and compliance monitoring, audits and corrective action.
    • Maintain up-to-date knowledge through professional reading, conference and seminar attendance. Attend workshops, trainings and meetings as needed and as requested. Perform other duties as assigned by Chief Administrative Officer.
    • Oversees follow-up and, as applicable resolution to investigations and other issues generated by Quality and Compliance Review activities, including development of corrective action plans, as needed.
    • Performs other related duties as may be assigned by the Chief Administrative Officer, and/or Chief Executive Officer.

    Qualifications

    • Well-developed verbal and written communication skills in English; Additional language abilities desirable.
    • Understands the importance of maintaining confidentiality; able to maintain confidentiality under HIPAA standards.
    • Must have the ability to exercise a high degree of diplomacy and tact; excellent customer services and interpersonal communication skills; Cultural sensitivity and demonstrated ability to work with diverse people groups.
    • Proven ability to effectively manage professional–level employees.
    • Ability to work well under pressure with minimal supervision. Proven flexibility and willingness to handle a variety of tasks.
    • Willingness to work evenings and/or weekends.
    • Proven ability to problem-solve and follow through with effective solutions.
    • Excellent organizational and administrative skills with meticulous attention to detail.
    • Valid California Driver’s License, insurance, and ability to accept travel assignments as required to perform duties.

     

    EDUCATION AND EXPERIENCE

    • Bachelor’s degree in Health Care Administration, Public Health or Social Science related field. MPH, MHA, MBA preferred.
    • Knowledge in FQHC standards of practice, legal and ethical codes and regulations applicable to FQHCs highly preferred but not required.
    • Training and/or experience in a clinical/medical highly preferred but not required.
    • Knowledge and work experience in risk management and quality/ process improvement required. Minimum two years’ experience in healthcare preferred

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