Progressive Community Health Centers, Inc.
  • Milwaukee, WI, USA
  • Salary
  • Full Time

JOB SUMMARY

The Corporate Compliance Officer is responsible for managing the corporate compliance program (which includes comprehensive annual assessment, internal audit, HRSA mock audits, internal compliance committee, compliance education, and compliance hotline management). This individual also functions as an independent resource from the operational management to evaluate compliance issues/concerns raised within the organization. The position ensures the Board of Directors, management and employees are in compliance with the rules and regulations of state and federal regulatory agencies as well as HRSA regs, 340B, GAAP, HIPAA, FTCA, CMS and any other company policies and procedures that meet the company's standards for ethical conduct.

Responsibilities

  • Develop and implement a Compliance Program for Progressive Community Health Centers that produces individualized compliance assessment
  • Maintain an up-to-date knowledge of federal and state rules and regulations that govern a Federally Qualified Health Center
  • Oversee and monitor the development and implementation of Progressive Community Health Centers Compliance Program annual work plans
  • Identify high risk areas and potential areas of compliance vulnerability through risk assessment
  • Identify methods to reduce vulnerability to fraud and abuse
  • Develop and coordinate a training program that focuses on the components of the Compliance Program and that seeks to ensure that all Individuals Affiliated with Health Center are knowledgeable of, and comply with, pertinent federal and state standards and Compliance Program and Standards of Conduct
  • Perform audits as needed and act as an independent review and evaluation body to ensure that compliance Issues and concerns are being evaluated in preparation for periodic HRSA site visits
  • Develop, initiate, maintain, and revise policies and procedures for the general operation of the Compliance Program and its related activities
  • Develop and periodically review and update Standards of Conduct to ensure continuing currency and relevance in providing guidance to management and employees
  • Collaborate with departments to direct compliance issues for investigation and resolution
  • Respond to alleged violations of rules, regulations, policies and procedures by evaluating or recommending the initiation of investigative procedures
  • Provide reports on a regular basis to senior management and Board of Directors to inform on the operation and progress of compliance efforts
  • Ensure proper reporting of violations or potential violations to duly authorized enforcement agencies
  • Institute and maintain an effective compliance communication program for the organization
  • Work with the Human Resources, Finance, Medical and Operations as appropriate to develop an effective compliance training program
  • Maintain strict confidentiality about individual health center findings and proprietary information.

Complexity of Work

The Corporate Compliance Officer acts as staff to the CEO and to the Board of Directors' Quality Committee by monitoring and reporting results of the compliance efforts of Progressive Community Health Centers and in providing guidance for the Board and senior management team on matters relating to compliance. The Corporate Compliance Officer is authorized to implement all necessary actions to ensure achievement of the objectives of an effective compliance program.

Core Competencies

  1. Accountability and Getting Results
  2. Building Trust
  3. Communicating (Written and Oral)
  4. Continual Learning
  5. Initiative
  6. Interpersonal Skills
  7. Maintaining Personal Credibility and Meeting Ethical Standards
  8. Solving Problems
  9. Technology Use/Management
  10. Valuing and Leveraging Diversity and Inclusion

Minimum Qualifications

EDUCATION

  • Bachelor's degree required
  • Master's degree or Juris Doctor preferred.



EXPERIENCE:


  • 3+ years of experience in health care compliance required.
  • 5+ years of experience in health care compliance in a management capacity preferred.
  • Demonstrated investigatory skills, including document review and interviewing people as part of ongoing investigations.
  • Knowledge of, and experience with, patient privacy laws and regulations, including but not limited to HIPAA, FTCA, GAAP, Medicare/Medicaid, 340B
  • Working knowledge of regulatory and billing compliance for FQHCs.
  • A knowledge in physician practice billing is preferred.
  • Knowledge of state and federal regulations, Medicare and Medicaid and third-party payer regulations and guidelines
  • Advanced computer skills with proficiency in Excel, Word, and Power Point.
  • Must have ability to analyze data and make data driven strategic decisions.
  • Must possess outstanding interpersonal relationship skills.

Full Job Description
Progressive Community Health Centers, Inc.
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