Clinica Sierra Vista · 5 hours ago
Risk and Compliance Analyst I - Kern Admin
Bakersfield, CA, US
Full-time
Onsite
Entry Level
$64K/yr - $79K/yr
1+ years expClinica Sierra Vista is one of the largest Federally Qualified Health Centers in the Nation, dedicated to serving diverse communities. The Risk and Compliance Analyst I will assist in developing and managing the Compliance Program and Risk Management Plan, ensuring adherence to regulations and conducting audits to mitigate risks.
Health CareHealth InsuranceMedical
Responsibilities
Conducts regular on-going review of Compliance Plan and Risk Management Plan in addition to all relevant state and federal statutes and regulations with duties including but not limited to:
Working with the Chief Human Resources & Compliance Officer, Manager-Compliance, and Chief Administrative Officer to monitor changes in contractual provisions or regulations and communicate those changes to relevant staff within the organization
Tracking regulatory updates from agencies such as The Joint Commission (TJC), HRSA, OSHA, FTCA, and revising annual compliance and risk employee trainings to ensure requirements are met
Assisting the Compliance and Risk Analyst II in ensuring that all quarterly risk assessments are completed and findings have been communicated timely to allow for proper quality corrective actions to be completed
Assisting the Manager-Compliance in completing submissions to regulators
Assisting the Manager-Compliance in distributing open patient safety reports to respective departments
Facilitates the proper handling of all claims/suits brought against the organization
Participates in the proper handling of all patient complaints and incident reports supporting the Grievance Analyst
Review policies and procedures to satisfy relevant state, federal, and/or industry standards and requirements and coordinate efforts with appropriate departmental staff to ensure implementation with duties including but not limited to:
Supporting consistency in policy content and format throughout the organization
Coordinating efforts with appropriate departmental staff to verify that CSV practice matches plan policy; and
Working with departments to revise policies and/or practices so that they are aligned and satisfy regulatory requirements
Assists in the implementation of audit processes to ensure compliance with federal and state statutes and regulations and program guidance for the CSV Compliance Program
Supporting the audit program, implementing, and conducting ongoing risk assessment processes at least quarterly
Conducting audits, analyzing information, identifying deficiencies, developing reports and formulating recommendations for corrective action
Conducting review of incident reports, analyzing information, identifying trends, develop reports and formulating recommendations for opportunities to mitigate risk
Informing the Manager-Compliance regarding situations of non-compliance
Working with department directors and managers to implement corrective action plans, such as enhancement of employee trainings, review and improvement of processes in situations of non-compliance, monitoring progress and ensure completeness
Monitoring compliance risks and ensuring that the departmental staff responds timely
Responds to external requests for information, with duties including but not limited to:
Responding to audit requests
Responding to subpoena requests
Insurance requests such as proof of certificate of insurance
Coordinating responses from appropriate department directors and managers
Assisting in the preparation of Corrective Action Plans
Assisting in the preparation of responses to additional information requests and patient comment letters, as needed
Performs other duties as assigned
Qualification
Required
Bachelor's degree in Business or Public Administration, Public Policy, Health Care Planning, or a related field required
1 year of Compliance/Risk experience within the health care industry required; ambulatory care setting preferred
Knowledge of medi-cal, public assistance programs
Knowledge of principles of health care planning and administration
Knowledge of health care regulatory policies
Knowledge of State and Federal legislative processes
Knowledge of research, analysis and reporting methods
Knowledge of and ability to utilize conflict resolution and problem-solving techniques
Knowledge of and proficiency in the use of Microsoft Word, Excel and PowerPoint software is required
Ability to analyze and interpret legal and contractual language
Ability to research, write, and develop policies and procedures
Ability to develop and organize electronic and paper filing systems
Ability to define issues, interpret data and evaluate options
Ability to create forms and letters, compile reports and various information as required
Ability to effectively, clearly and independently document, summarize and resolve complex issues
Reasonable and predictable in person attendance
Preferred
Knowledge of compliance, quality improvement practices and audit techniques, or an equivalent combination of education and experience which would provide the required knowledge
Clinical experience as a Medical Assistant or Licensed Vocational Nurse preferred
Benefits
Health coverage for you and your family
Generous number of vacation days per year
A robust wellness plan and health club discounts
Continuing education assistance to grow and further your talents
403(B) plan with company matching
Company
Clinica Sierra Vista
Clinica Sierra Vista is a healthcare organization that provides medical, counseling, behavioral and insurance services.
1001-5000 employees
Funding
Current Stage
Late StageLeadership Team
Olga Meave
Chief Executive Officer
Paula Zandi
Deputy CFO
Recent News
The Business Journal
2024-02-19
The Business Journal
2023-10-21
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