The Sr. Analyst, Compliance and Privacy provides support for all operations and initiatives critical to enterprise-wide Compliance and Privacy Program needs. Through effective partnerships with business unit stakeholders, this individual supports team functions, which include, but are not limited to, preparation for, and coordination of regulatory and other external audits, investigations and response to allegations of non-compliance, delivery of compliance and privacy related education, compliance and privacy related policy and procedure drafting and maintenance, and auditing work plan and monitoring activities. This experienced professional effectively responds to privacy and compliance inquiries of high complexity while assessing and mitigating elements of organizational risk. The Sr. Analyst, Compliance and Privacy demonstrates exercise of independent judgment related to situations of a sensitive, confidential nature and is responsible for varied and extensive duties requiring considerable initiative and ability to make decisions relative to efficient program operations.
Duties/Responsibilities: Independently manages compliance and privacy projects of high complexity to the desired outcome.Establishes and executes on program work plan items within compliance specialty area.Develops, implements, and maintains compliance policies and procedures.Serves as compliance auditing, investigation and consulting resource to organization. Provides consultation on internal and external requirements. Evaluates regulatory requirements and potential operational impacts. Advises operational units on policy, procedure, and operational work plans development.Provides project management, coordination, and analytical support for compliance projects.Performs risk assessment and mitigation activities and audits related to compliance. Conducts initial and periodic assessments, risk analysis, and audits.Develops and monitors corrective action strategies and action plans. Communicates status of same to leadership.Monitors and keeps leadership abreast of regulatory issues, deficiencies, or potential problems that may have financial impacts or involve regulatory intervention activities.Communicates regulatory issues, deficiencies, or potential problems as they relate to possible financial impacts and/or regulatory intervention activities. Develops implements and coordinates training programs.Assists in identification of compliance program needs. Recommends and develops strategies and plans to address the same. Develops supporting documentation for compliance program. Reviews and revises Compliance department work plan on regular basis.Assist with investigating allegations of non-compliance or regulatory violations, including those received from the anonymous or confidential hotline. Reports findings and resolutions to leadership.Assist with the implementation of Compliance program communication and training plans, including collaborating with other corporate support teams' business units.Provide guidance with interpreting regulations and health plan guidelines.Trains and develops staff and appropriately discerns and escalates issues that require management and communication upward.Required Skills/Abilities: Ability to review, analyze, and interpret regulatory requirements in a clear and concise manner.Demonstrated organization, analytical, facilitation, communication, presentation skills.Excellent interpersonal skills with the ability to build relationships that effectively influence behavior.Detail-oriented with excellent follow-through to drive inquiries, consultations, and investigations to resolution.Demonstrated knowledge related to federal and state laws and regulations.Demonstrated ability to consult, advise, and translate customer needs into solution alternatives.Demonstrated knowledge of and skill in communication, problem solving, project management, and risk assessment.Demonstrated knowledge of and skill in word processing, multimedia presentations, spreadsheet, database, project management, and desktop applications.Ability to analyze and respond to complex compliance subject area scenarios independently.Advanced professional writing skills.Minimum Qualifications: Bachelor's degree in healthcare, Business Administration, or another approved related field required. Graduate level degree preferred.Two (2) to five (5) years of experience working in an outpatient care setting.Two (2) to five (5) years of compliance, privacy, risk, auditing, or legal experience required.Experience using compliance platforms such as SAI 360 or other compliance software strongly preferred.HCCA certification preferred.
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