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Operations Compliance Manager

Company: Sansum Clinic
Location: Santa Barbara
Posted on: March 27, 2020

Job Description:

As our Compliance and Privacy Officer focusing on business operations and revenue cycle, we here at Sansum Clinic are looking for you to bring your expertise to our growing "We Care" Executive Team. What does that look like as this person builds a framework for internal audits and compliance programs? If you consider yourself a leader who strives for a collaborative big picture as well as details approach who can not only drive compliance but can engage with the community we are looking for you. You do not have to be an attorney to support this postion. To apply directly please visit us at: www.sansumclinic.org/employmentReporting to CEO and to the Audit Committee of the Board of Trustees, the principal responsibility of the Compliance and Privacy Officer is to establish, maintain, and oversee an effective compliance and ethics program for Sansum Clinic consistent with the provisions of the Federal Sentencing Guidelines as well as establishing and implementing an effective compliance program to prevent illegal, unethical, or improper conduct. You will work with the Compliance or Audit Committee, and implement all necessary actions to achieve the objectives of an effective compliance program in accordance with the mission, vision and values of the organization. Oversee all ongoing activities related to the development, implementation, maintenance of, and adherence to the Clinic's policies and procedures covering the privacy of, and access to, patient health information in compliance with Federal regulations and State statutes as well as with the Clinic's privacy, security, and compliance policies and practices.ESSENTIAL FUNCTIONS AND RESPONSIBILITIESDevelop, initiate, maintain, and revise policies and procedures for the general operation of the compliance program and its related activities to prevent illegal, unethical, or improper conduct.Conduct a variety of reviews and audit to ensure regulatory compliance. Maintain a consistent audit and review schedule including randomized and sampled audits of coding and other operational and financial areas.Develop and maintain key organizational documents including the Code of Conduct and Corporate Integrity Agreement.Drive efforts to optimize related policies, processes and systems by identifying issues, combining best practices (e.g., inside and outside of Sansum Clinic) and developing, proposing and implementing solutions. Influence outcomes and resolutions with executive leadership.Serve in an advisory role for senior/executive management with respect to ethics and compliance issues.Develop and deliver compliance training at company and departmental meetings (including training directed to the company's compliance reporting and investigations program).Provide legal support primarily including, but is not limited to: drafting and reviewing both routine and non-routine contracts and other non-litigation legal documents; providing legal advice for certain transactional matters; advising administrators, and others on federal and state laws and regulations.Develops and periodically reviews and updates Standards of Conduct to ensure continuing timeliness and relevance in providing guidance to management and employees.Respond to alleged violations of rules, regulations, policies, procedures, and Standards of Conduct by evaluating or recommending the initiation of investigative procedures.Identifies potential areas of compliance vulnerability and risk, develops and implements corrective action plans for resolution of problematic issues, and provides general guidance on how to avoid or deal with similar situations in the future.Ensure proper reporting of violations or potential violations to duly authorized enforcement agencies as appropriate or required.Monitor the performance of the Compliance Program and relates activities on a continuing basis, taking appropriate steps to improve its effectiveness.Provide proactive guidance and consultative assistance in the identification, implementation, support, and maintenance of information confidentiality protection and record security safeguards.Coordinate with Clinic administrative and management staff in designing, delineating, interpreting, and enforcing the Clinic's patient privacy policies and information security procedures and practices.Work with key staff in maintaining an organization-wide privacy and security oversight committee and other HIPAA-related committee.Performs, facilitates, or supports periodic patient privacy risk assessments.Consults with legal counsel and executive team as necessary and collaborates with key department heads and committee chairpersons to ensure that the organization maintains all HIPAA requirements regarding patient communications, as well as instructional or clarifying materials and resources that provide or reflect current HIPAA-compliant privacy and security procedures and practices for Clinic personnel use.Direct, assist, coordinate, or otherwise ensure delivery of mandated confidentiality training and related workforce education programs pertinent to patient privacy and document security as required by the HIPAA Rules.Participate in the design, development, and implementation of continuous compliance monitoring systems involving employees, business associates, and subcontractors.Ensure that mechanisms are in place as required by law for (a) tracking access to, and disclosures of, PHI; (b) performing audits and generating audit trails when requested and warranted; and (c) allowing qualified individuals to receive, review and share audit results as permitted.Ensure that patient rights for inspecting, copying, amending, and releasing medical records are upheld and that patients may request to restrict access to PHI or to limit its disclosure to third party requestors as provided by HIPAA.Administer a process for receiving, documenting, tracking, investigating, and pursuing all complaints concerning the organization's privacy policies and procedures in coordination with other Clinic departments (e.g. human resources, quality management, risk management, information technology, etc.) and, when necessary, with legal counsel and the executive team.Ensure compliance with Clinic privacy practices and consistent application of sanctions in cooperation with human resources, compliance officer, security officer, the privacy and security committee, and legal counsel.Initiate, facilitates, and promotes activities fostering patient privacy, systems security, and record confidentiality awareness within the organization and among patients, affiliates, and business associates.Serve as member of, or liaison to, the Clinic's independent review board (IRB) when assigned to do so and as representative or liaison for users of clinical PHI and document management systems.Review pertinent system-related information security plans to ensure enterprise-wide alignment or consistency between security measures and privacy practices.Keep up with relevant Federal regulations, State laws, accreditation and industry standards, and business partner policies and procedures, and monitors advancements in information technologies and best practices to ensure organizational awareness where necessary and possible adaptation.Respond to external government requests for input in the development, adoption, amendment, or enforcement of privacy regulations, legislation, or standard.

Keywords: Sansum Clinic, Santa Barbara , Operations Compliance Manager, Executive , Santa Barbara, California

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