HealthHelp · 6 hours ago
Chief Compliance Officer
United States
Full-time
Remote
Director/Executive
$225K/yr - $250K/yr
10+ years expHealthHelp is seeking a Chief Compliance Officer to maintain and enhance its Compliance Program. The role involves developing compliance policies, advising executive management on regulatory risks, and overseeing compliance audits and staff management.
Health Care
Hiring Manager
Sarita R.
Responsibilities
Maintain Compliance program in HealthHelp through setting long and short term strategic objectives and priorities; and enhance the effectiveness of HealthHelp Compliance Program
Develop, maintain and update compliance policies and procedures, tools and standards for all activities to ensure compliance with applicable federal and state laws and regulations and mitigate future compliance risks
Advise HealthHelp Executive Management Team and Board of Directors of potential regulatory risks, gaps, and issues; implement and lead corrective actions
Prepare the annual Corporate Compliance Plan and lead HealthHelp through any internal and external regulatory audits
Develop, lead and manage compliance program responsibilities including monitoring, testing, annual reviews, and tracking
Manages a prompt response to detected compliance issue by identifying the root cause, propose corrective action and implement/monitor such plans through the organization
Oversee Compliance Hotline Program. Delegate investigations to appropriate departments, i.e. HR, Compliance, etc. and manage them through resolution
Coordinates auditing activities with various department heads to monitor compliance with internal policies and procedures for the management of health plan customer delegated tasks
Develop and/or manage compliance staff across multiple compliance program activities
Ensures compliance with NCQA and URAC standards and client contractual deliverables by coordinating timely completion of action items and submission of monthly, quarterly, and annual reports
Coordinates compliance reporting requirements by overseeing the timely collection of data from various departments and presenting them to the appropriate entities
Educates team members as needed on NCQA, URAC and HIPAA requirements
Assists with the preparation for and interim assessment of HH’s “survey-ready” status for client or regulatory agency reviews
Provides oversight to physician licensing and credentialing processes
Lead a risk-based program of auditing and monitoring activities, including the selection of appropriate internal and external resources to support the program
Lead training initiatives including creating and delivering associate training regarding regulatory compliance requirements
Other duties as assigned by management in furthering compliance
Qualification
Required
10 or more years of progressive experience in healthcare compliance, internal audit and operations required
Bachelor of Science degree in accounting, healthcare administration, business or related field is required
Demonstrated experience in HIPAA regulations
Demonstrated experience in Fraud, Waste and Abuse (FWA) reporting
Working knowledge of state and federal regulations, CMS, health plan, healthcare provider and health system requirements
Must have ability to analyze data and make data-driven strategic decisions
Excellent organizational and training skills
Excellent verbal and written communication skills
Excellent ability to maintain confidentiality and integrity
Must possess excellent interpersonal relationship skills
Preferred
5 years of experience in healthcare compliance management preferred at a manager level in a health plan
A graduate degree in business or healthcare administration and certification as a CHC (Certified in Healthcare Compliance) is preferred
Company
HealthHelp
HealthHelp collaborates with payors and providers to ensure patients receive the right care at the right place and at the right time.
10001+ employees
Funding
Current Stage
Late StageTotal Funding
unknown2017-03-15Acquired
2008-01-01Private Equity
Leadership Team
Shea Helmle
Chief Executive Officer
Mark Conroy
Chief Information Officer
Recent News
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