Senior Compliance Analyst

ESSENTIAL FUNCTIONS AND DUTIES

• Maintains knowledge of SCHS policies, procedures, and organizational standards and processes that support the seven elements of an effective compliance program as defined by the Office of the Inspector General.
• Serves as a collaborative resource to SCHS leadership, employees, and medical staff on compliance-related topics and issues and acts as a senior subject matter expert for complex or high-risk compliance concerns.
• Identifies compliance risk through a collaborative risk assessment process with key stakeholders, including the Compliance Steering Committee, and is a key contributor to the enterprise-wide compliance risk assessment by incorporating relevant information obtained through internal audits and investigations, the compliance hotline, the OIG work plan, and recent enforcement trends.
• Supports the organizational response to compliance-related notices as requested by the Chief Compliance Officer.
• Assists in responding to regulatory investigations and periodic payor audits and assessments and may lead complex or high-risk responses to audits and investigations as assigned.
• Investigates and responds to reports of legal, regulatory, or policy violations and other compliance concerns received from SCHS caregivers and others, including leading complex, sensitive, or high-risk investigations and ensuring appropriate resolution and follow-up.
• Works with leadership to recommend and establish policies and procedures to address legal, regulatory, and other compliance-related matters and leads development or enhancement of policies addressing enterprise compliance risks.
• Participates in and serves on SCHS committees, collaborates with business, operational, legal, and compliance stakeholders, and supports all compliance-related processes and activities, including without limitation, monitoring 340B program activities, OIG exclusion list compliance, annual compliance education & training, and OIG Audit Plan risk assessments.
• May lead subcommittees or workgroups as assigned.
• Partners with members of the compliance department, including privacy officers, internal auditors, and other compliance staff, to design the annual compliance, privacy, and audit plans and plays a key role in shaping and prioritizing those plans based on risk.
• Creates and maintains appropriate documentation of all compliance activities.
• Develops, executes, and manages detailed project plans and status reports for complex or enterprise-level initiatives.
• Serves as the Revenue Integrity and refund liaison.

Qualifications

• Bachelor’s degree in a Health Science, Accounting, Business Administration, Pre-Law, Nursing, Health Information Management, or related field.
• Healthcare compliance or equivalent compliance certification (ex. CHC, CHRC, CHPC, CHC-F, or CCEP).
• Valid Oregon driver's license and ability to meet SCHS driving requirements.
• Experience in a hospital or health system setting with a minimum of five (5) to seven (7) years of healthcare compliance experience.
• Demonstrable knowledge and understanding of the healthcare industry’s regulatory environment.
• Skilled in researching state and federal laws, rules, and regulations.
• Familiarity with a variety of healthcare organizational constructs (home health, hospice, provider-based clinics, co-location, and JVs, etc.).
• Experience with Epic EHR.