Compliance Manager

About the role

The compliance manager will support a strong culture aligned with the seven elements of organizational compliance, just culture, adherence to relevant laws, regulations, policies, and standards. This position is responsible for maintaining regular, consistent, and predictable punctuality and attendance, coordinating the overall operations of La Clinica’s Organizational Compliance functions, and ensuring clear open lines of communication.

Responsibilities

• Maintains regular, consistent, and predictable punctuality and attendance, including being available, accessible, and able to complete all required essential functions and assigned job tasks onsite as directed during your regularly assigned schedule or your assigned site(s) normal business hours.
• Captures and coordinates the overall operations of La Clinica’s Organizational Compliance functions in alignment with strategic goals and regulatory obligations.
• Works closely with La Clinica’s assigned Compliance Officer and Privacy Officer.
• Ensures and oversees standard work processes to ensure up to date policies and procedures that are in line with regulatory requirements and support the vision, mission, and operating principles of the organization.
• Facilitates development of effective training and education programs to ensure workforce members are aware and kept up to date on expectations of their job performance relative to regulatory requirements, laws and ethics, and the organization’s code of conduct.
• Guides development and implementation of best practice assessments and security risk assessments for organizational processes to identify areas of strength, non-compliance, and vulnerabilities.
• Supports and guides the development and implementation of sustainable corrective action plans incorporating just culture methodology and framing all recommendations within organizational or regulatory workflows.
• Collaborate with the Human Resources Department and others to support investigations and ensure written policies and procedures clearly define violations of organizational or regulatory standards are dealt with fairly and consistently.
• Serves as point of contact to regulatory agencies and external auditors, assisting in the coordination and preparation of audits.
• Maintains a positive relationship with external stakeholders and responds promptly to inquiries for requests for information.
• Completes and submits required certifications, licenses, organizational credentialing/recredentialing, reviews and approval of providers CMS-855-R reassignment of benefits applications, and annual FTCA application.
• Collaborates on identifying metrics/key performance indicators and reporting structures specific to areas of responsibility.
• Works collaboratively with the Performance Excellence Team, Performance Excellence Director and Chief Quality Officer to develop annual Privacy and Performance Excellence Plans that incorporate compliance priorities.
• Stays up to date with applicable laws, regulations, industry standards and interprets and assesses how they impact the organization’s operations.
• Continuously develops and supports Lean culture throughout La Clinica.
• Serves as delegated privacy and content expert to ensure systems are in place for compliance with privacy rules, while being able to provide recommendations on closing gaps based on regulatory requirements or best practices.
• Other duties as assigned.

Qualifications

• A successful Compliance Manager must be able to interact with a variety of individuals at various levels under stressful circumstances while exercising sound judgement, tact, and diplomacy; work productively both independently and in a team setting; communicate with clarity, both verbally and in writing to groups of all sizes and levels; possess the confidence and ability to make effective and persuasive presentations on controversial or complex topics to workforce members, leadership, and the governing board.
• Minimum: Three to five years of experience in the field of healthcare compliance.
• Experience and working knowledge of quality improvement processes, just culture, and Lean methodology.
• Knowledge of statistics, data collection, analysis, and data presentation.
• Experience in providing training to workforce members, leaders, and governing board.
• Excellent interpersonal communication and problem-solving skills.
• Skills to intervene and promote reconciliation and positive outcomes in difficult patient/family/workforce interactions.

Skills

• Excellent interpersonal communication and problem-solving skills.
• Skills to intervene and promote reconciliation and positive outcomes in difficult patient/family/workforce interactions.