Senior Compliance Analyst

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Senior Compliance Analyst
The candidate will assist with the review and resolution conflict of interest and other regulatory matters. Will be responsible for management of assigned internal compliance audits, recommendation and oversight of corrective action plans, and compliance education. Will interact with internal and external compliance stakeholders and must be critical-thinking, thorough, and solutions-focused. Bachelor’s degree in health/public/business administration, public policy, health information management, or related field required. Advanced degree in a related field (such as MHA, MPA, MBA, JD) preferred. 4+ years’ experience in a healthcare (or translatable) setting with compliance programs, regulatory research, auditing, and/or policy and procedure development required. Compliance investigation experience. Experience in management of compliance programs preferred. Certified in Healthcare Compliance (CHC) desired at time of or within 18 months of hire. Other desired certifications: Certified in Healthcare Privacy Compliance (CHPC); Certified Professional Coder (CPC); Certified Coding Specialist (CCS). Epic or eClinicalWorks EMR experience. Proficiency with Microsoft Word, Excel, and SharePoint. Independently manage all aspects of compliance education, sanction screenings, incident investigation and response, and assigned audit projects. Deliver exceptional work products for these subject areas. Create and lead teams to address and resolve compliance matters in an effective and efficient manner. Uphold compliant and ethical behavior in all situations and be an ambassador at all times for the Compliance Program. Address and resolve privacy matters, including coordination of notification and follow up. Perform internal audits and reviews of processes in a thorough and structured manner. Review of billing/reimbursement activities and application of CPT, ICD, Medicare NCDs/LCDs rules. Create collaborative, effective workgroups of internal and external stake holders. Research, synthesize, and apply various complex state and federal healthcare regulations. Create audit reports, policies and procedures, or other department communications. Data analysis, including ability to manipulate data in Microsoft Excel and Access. Participation in and contribution to the risk assessment and work plan creation process. Verbal communication and ability to present compliance education to various audiences. Strong customer service acumen in responding to and dealing with both internal and external stakeholders. Organize, track, and resolve compliance matters as they arise. Perform exclusion screening of employees and vendors against OIG, SAM, and state Medicaid exclusion lists. Facilitate, plan, and coordinate compliance meetings with internal and external stakeholders.

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