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Organization TypePublic Interest
Years of Experience
Date Last Verified
ProfileRegional Compliance Administrator Responsibilities: Responsible for the following regional compliance activities: administrative and care delivery compliance and associated investigation functions; privacy compliance functions and any associated investigations; facility and practice auditing and monitoring including completion of assigned risk assessments; compliance training and awareness; fraud, waste and abuse prevention and detection; issue tracking and reporting; and follow-up on any corrective action or performance improvement plans. Responsible for addressing compliance issues and for acting as the primary compliance liaison between their assigned facilities and medical group practices and the following areas or entities: Finance, Patient Financial Services (PFS); Conifer; Health Information Management Services and any contract release of information vendors; Contracts Management; Risk Management; Quality; and Legal. Acts as the primary compliance liaison to resolve complex matters or issues for their assigned facilities and practices. Represent the department on assigned facility and practice based committees and forums. Provides support for hospital or practice based staff responsible for fraud control programs (including the Medicaid program integrity program), care delivery compliance activities, revenue cycle compliance and facility compliance.
Qualification and Experience
Qualifications: Bachelor’s Degree in health care related field required. Masters or JD Degree preferred. Required Ability to obtain Certification in Health Care Compliance (CHC) within 6 months of hire; Certification in Health Care Compliance (CHC), Healthcare Privacy certification (CHPS or CHPC), preferred; Licensed RN or other health care discipline licensure preferred. 5 years of professional experience with 3+ years in a compliance/ risk management role or as a health law attorney required. 3 years of experience conducting or managing complex investigations required. 1-2 years in health care operations preferred. Strong interpersonal skills, including the ability to interact effectively with Medical Staff, Executives, facility/practice management and staff; Corporate Associates and the general public. Ability to interact with IT professionals, in-house and outside counsel, law enforcement and care delivery professionals required. Ability to be flexible, creative and motivated by challenges. Ability to initiate, coordinate and follow multiple projects through to completion. Knowledge of hospital practices and procedures as well as laws, regulations, and guidelines pertaining to healthcare. Knowledge of HIPAA, Stark, and False Claims Act. Demonstrated ability to work independently and to motivate people to achieve shared. Results-oriented, analytical and creative thinker with excellent written and oral communication skills and the highest level of personal integrity. Knowledge of health care compliance policies, practices, and systems. Experience with Fairwarning audit software program and Compliance 360 preferred.
Job ID: 2017-6113
WellStar Health System
805 Sandy Plains Road
Marietta, GA 30066