To design, manage and execute compliance projects/program across the system, diverse departments, and populations. Serves as project manager in collaboration with key stakeholders to improve organizational compliance with federal and state healthcare laws and regulations. This position is responsible for supporting the execution of compliance projects and supporting and managing assigned compliance programs.
PRINCIPAL DUTIES AND RESPONSIBILITIES:
Coordinate, support and proactively maintain a mandatory Compliance Training program, this may include focused, specific, corrective action, and/or routine, including content, distribution, and completion tracking.
Leads the annual compliance training campaign for employees and medical staff; working with the compliance operations, billing & clinical teams, senior leaders, and key department stakeholders to ensure training is current, relevant, and innovative. Evaluate training methods and modalities and work with the iLead team to implement.
Assist in development of organizational compliance auditing/monitoring activities, including periodic reviews of the individual department auditing/monitoring functions.
Support or conduct focused audits/reviews to investigate adherence with policies, and legal/regulatory requirements and to identify and evaluate exposure resulting from defective compliance monitoring processes.
Develop Corrective Action Plans to address deficiencies identified by auditing/monitoring activities in specific departments or on an organization-wide basis.
Implement and maintain a system of management reporting that provides timely and relevant information on all aspects of auditing/monitoring and compliance issues.
Direct efforts to communicate compliance initiatives, including written materials and training programs, designed to promote awareness, and understanding of compliance issues, the Organizational Code of Ethics and related law, regulations and government directives or guidance.
Assist in promotion of a corporate culture that fosters ethical and compliant behaviors and provides the basis for ensuring adequate controls to maintain compliance with law, regulations, and payer requirements throughout the Health System.
Coordinates and participates in the quarterly Corporate Compliance meetings, as assigned.
Interpret statutes, regulations, and regulatory communications for potential impact on the health system.
Implement and maintain a compliance monitoring program/plan for assigned Corporate Compliance programs/projects.
Develop and maintain effective formal and informal relationships with internal departments, subsidiaries, and third-party administrators to enhance understanding of compliance and regulatory requirements.
Lead and/or participate on project teams and coordinate interdepartmental resources to successfully implement new legislative changes.
Implement or direct development of organizational policies and procedures to guide and support compliance with federal and state laws and regulations.
Recommends resources to support compliance projects and meet organizational needs.
Provide consultation on compliance matters to facilitate decision-making at all levels of management.
Identifies opportunities for improvement and alternate strategies when goals are not met.
Actively participates in system wide management activities, attends meetings and in-service/educational
programs and other activities as requested.
Maintains required credentials; assume responsibility for ongoing professional growth; exhibit a high level of
professionalism; act as role model for staff and others in the organization.
Maintains confidentiality of patient/members and staff information.
Performs assigned work safely, adhering to established departmental safety rules and practices; reports to supervisor, in a timely manner, any unsafe activities, conditions, hazards, or safety violations that may cause injury to oneself, other employees, patients and visitors.
Performs other related duties as required.
SCOPE, PURPOSE, AND FREQUENCY OF CONTACTS:
Regular and consistent contact with members of Corporate Compliance Leadership, Legal, Privacy, Information Security, Management, department chairs, department heads, ancillary department leaders such as Medical Audit, Patient Financial Services, Risk Management, and Health Information and Management Services.
DIRECTION/SUPERVISION OF OTHERS:
DIRECTION/SUPERVISION RECEIVED: Reports directly to the Corporate Compliance Officers
EDUCATION AND EXPERIENCE REQUIREMENTS:
Master's degree preferred.
Minimum of 4 years' experience in health care compliance or related activities.
Experience leading, facilitating and participating in multi-disciplinary teams required.
KNOWLEDGE, SKILL, AND ABILITY REQUIREMENTS:
Knowledge of federal and state laws and regulations that govern healthcare, including Accountable Care Organizations.
Knowledge of or ability to learn project management methodologies, tools, and strategies
Knowledge of health care delivery organizational structure and clinical care.
Knowledge of information systems.
Skilled in oral and written communications, including negotiating.
Understands the linkages between training designs and organizational curriculum and ability to evaluate training
Ability to advocate, engage key stakeholders and lead change management
Ability to plan, organize, direct and control multiple projects.
Ability to facilitate, motivate and manage various working team members and projects.
Ability to work as team player to accomplish project goals.
Ability to demonstrate excellent interpersonal skills
Ability to use Microsoft office programs (Word, Excel, Powerpoint, Process Flow charts and other PI
tools) for daily work and data input and retrieval.
Ability to adapt and learn new computer programs, as necessary.
Ability to collaborate with clinicians and other staff.
Ability to exercise tact, judgment, and diplomacy.
Ability to relate to people in a manner to gain confidence and establish support.
Ability to maintain confidentiality.
Ability to adjust to changing work demands necessitated by fluctuations in workload or program
Must be Certified in Healthcare Compliance (CHC) or Certified Professional Coder (CPC) or Certified Coding Specialist (CCS)
Walking to and from offices/campus sites and patient care areas; travel between System campuses and
private offices accessing all areas of the system as required.
Intermittent and sustained periods of sitting and using computer terminal.
Normal office environment.
EEO Statement: Christiana Care Health System is an equal opportunity employer, firmly committed to prohibiting discrimination, whose staff is reflective of its community, and considers qualified applicants for open positions without regard to race, color, sex, religion, national origin, sexual orientation, genetic information, gender identity or expression, age, veteran status, disability, pregnancy, citizenship status, or any other characteristic protected under applicable federal, state, or local law.
UPDATE: ChristianaCare is committed to prioritizing the health and safety of our patients and caregivers. As we continue to meet the needs of our caregivers and our community through the COVID-19 pandemic, our commitment to health and safety requires that we take new steps to ensure a safe environment for medical care for our patients and a workplace that avoids preventable harm for our caregivers. For this reason, vaccination for COVID-19 is required for all caregivers at ChristianaCare and is considered a safety standard that is job-related and consistent with business necessity for all caregivers.
ChristianaCare Health System is headquartered in Wilmington, Delaware and is one of the country's largest health care providers, ranking 21st in the nation for hospital admissions. Christiana Care is proudly a Nurse Magnet recognized institution. Christiana Care Health System is also one of the largest health care providers in the mid-Atlantic region, serving all of Delaware and portions of seven counties bordering the state in Pennsylvania, Maryland and New Jersey. A not-for-profit, non-sectarian health system, Christiana Care includes two hospitals with more than 1,100 patient beds, and is a major teaching hospital with two campuses. Christiana Care is continually recognized for excellence on a regional and national level. Our role in the community is expressed in the Christiana Care Way: "We serve our neighbors as respectful, expert, caring partners in their health. We do this by creating innovative, effective, affordable systems of care that our neighbors value."Christiana Care is a great place to work because we value diversity and recognize it to be a core part of our success. Because of the diversity of our employees, affiliated health professionals and volunteers, we are ...positioned to meet the unique needs of our patients and community. We acknowledge and celebrate the uniqueness and talent of each employee. Because of our talented workforce we are able to provide a quality healthcare experience to our patients and community. We strive to create an inclusive environment in which individual diversity can be leveraged and thrive. Christiana Care Health System is an equal opportunity employer, firmly committed to prohibiting discrimination, whose staff is reflective of its community and considers qualified applicants for open positions without regard to race, color, sex, religion, national origin, sexual orientation, genetic information, gender identity or expression, age, veteran status, disability, pregnancy, citizenship status, or any other characteristic protected under applicable federal, state, or local law.