Compliance Officer

POSITION PURPOSE:

Under the supervision of the Chief of Staff, with direct line of reporting to the Chief Executive Officer and the Board of Directors, the Compliance Officer supports and manages effective organization wide Compliance Programs. The Compliance Officer is responsible for maintaining organizational compliance with the rules and regulations of regulatory and funding agencies.  They oversee the organization policies and procedures program to ensure documents are maintained, relevant, and meet regulatory requirements. The Compliance Officer evaluates agency performance across Aviva Health compliance and risk management objectives while coordinating with management staff.  The Compliance Officer provides reports to the Board of Directors and to senior leadership on Compliance and Risk Management activities.

ESSENTIAL FUNCTIONS:

Monitors compliance with federal, state, and local regulatory requirements. Stays abreast of laws and regulations that might affect the organization’s policies and procedures.

Initiates, develops, maintains, and revises policies and procedures that ensures all departments are in compliance with applicable laws and regulations as well as appropriate standards of practice consistent with the general operation of the Compliance and Risk Management Programs.

Assures compliance with HIPAA, 340B program, OSHA, and any applicable Accreditation Standards.

Conducts day-to-day monitoring of clinical patient safety and risk management activities.

Performs quarterly risk management assessments.

Health center point of contact for claims management to include investigating, filing and managing all insurance claims for FTCA Deeming, Medical Malpractice, and Business Owner Insurance claims.

Provides support with insurance related correspondence; periodically reviews insurance policy coverage limits to assure adequate protection for the organization.

Is responsible to be the Aviva Health HIPAA/Privacy Officer.

Provides reports on a regular basis, and as directed or requested, keeping the Board and senior management informed of the operation and progress of compliance and risk management activity.

Collaborates with Medical, Dental, Accounting/Billing, and Administration departments to guide compliance activities, and assists in the development of corrective action plans.

Identifies potential areas of agency vulnerability and risk; develops/implements risk management plans and provides general guidance on how to avoid or deal with similar situations in the future.

Ensures proper communications are fulfilled to duly authorized government, regulatory, and enforcement agencies as appropriate and/or required.

Works with the Human Resources to develop an effective compliance training program, including introductory training for new employees as well as ongoing training for all employees and managers.

Liaison for external audit agencies and internal functional department.

Coordinates organizational preparation for, execution of, and follow up to Compliance audits and other external reviews.

Maintain library of Policies, Procedures, and SOPs required for external audits and reviews.

QUALIFICATIONS:

Experience: A minimum of 5 years’ experience in a healthcare organization, to include demonstrated leadership. Familiarity with health care related financial, quality assurance, and human resource procedures and regulations is a must.

Professional certification in Healthcare Compliance required.

Familiar with a variety of healthcare processes, concepts, practices, and procedures.

Strong organizational skills.

Ability to maintain and respect strict confidentiality.

Ability to maintain friendly, courteous, and respectful manner in all patient and staff encounters.

Ability to prioritize and work under deadlines.

EDUCATIONAL REQUIREMENTS:

Bachelor’s degree in Compliance or Health Care related field of study required; Master’s Degree preferred.

PHYSICAL REQUIREMENTS:

Hearing: within normal limits with or without use of corrective hearing devices.

Vision: adequate to read 12-point type with or without use of corrective lenses.

Must be able to verbally interact with staff, clients, and public.

Manual dexterity of hands/fingers for writing, computer input.

Able to lift up to 30 pounds; standing 10% of the day; walking 5% of the day; sitting 85% of the day; pushing/pulling up to 25 pounds.

WORKING CONDITIONS:

Work indoors in heat-controlled environment 75% of the time. Office environment. OSHA Exposure Category – Category #2: The normal work routine involves no exposure to blood, body fluids, tissues, or other contaminated materials.

Aviva Health is an Equal Opportunity Employer
We are committed to fostering a diverse and inclusive workplace where all qualified applicants receive consideration for employment without regard to race, color, religion, gender, gender identity, sexual orientation, national origin, age, disability, veteran status, or any other legally protected status.

Aviva Health is a Drug-Free Workplace

To ensure a safe and secure environment for our employees and patients, Aviva Health maintains a drug-free workplace. All employment offers are contingent upon passing a drug screening and a criminal background check. Compliance with these policies is required throughout employment.