Presbyterian Healthcare Services
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at Presbyterian Healthcare Services
- Requisition ID
- Default: Location : City
- Location : Name
- Rev Hugh Cooper Admin Center
- Default: Location : State/Province (Full Name)
- New Mexico
Type of Opportunity: Full Time
Work Schedule: Days
Supports the Director of Compliance by researching and communicating State and Federal laws, regulations and policies that impact PHS Operations. . Assist with the Compliance HOTLINE and related activities to include directing of issues to the appropriate compliance or operations personnel. Conducts investigations of suspected issues of non-compliance as directed by the Director of Compliance or Compliance Manager. Conducts compliance-related audits or monitoring projects, monitoring corrective action plans and review for performance to plan. Performs policy and procedure review. Develop and monitor compliance indicators for CDS and Regional facilities, Ambulance Services and Home Healths. In coordination with the Director of Compliance will work with the HIPAA Privacy Officer on issues related to privacy and Section 1557 of the Affordable Care Act.
*Facilitate interactions with Program, project, product line, senior executives, department managers, regional facility administrators and staff regarding regulatory compliance and related financial issues.
*Assist with the compliance HOTLINE process.
*Facilitates cross-functional teams to address compliance issues that cross multiple departments or entities. Assists in the development and implementation of policies and procedures to address identified compliance issues.
*Conducts official compliance investigations, audits and monitoring activities to assure compliance with applicable laws, regulations and policies and procedures.
*Assists the Director of Compliance and Compliance Manager in conducting annual risk assessments related to the OIG Workplan and PHS identified risk area.
*As directed by the Director of Compliance or Compliance Manager, assists contracted internal audit in assuring the appropriate follow-up on recommendations from previous contracted internal audits or projects.
*As requested by the PHS Compliance Privacy Officer, conducts investigations and/or monitors information privacy issues or issues related to Section 1557 of the Affordable Care Act.
*Conducts and/or coordinates operational, financial and compliance program audits as directed by the Director of Compliance.
*Conducts regulatory research and serves as a resource for compliance information on regulations applicable to integrated healthcare systems.
*Performs compliance review of policies and procedures.
*Serves as the Compliance Department contact for system-wide Compliance Liaisons and coordinates and leads regularly scheduled telephone conference calls with these liaisons and other compliance personnel.
*Reports potential fraud and noncompliance to the Director of Compliance and Vice President of Corporate Compliance.
*Assists in the development, implementation and improvement of internal controls needed to assure regulatory compliance and compliance with PHS policies and procedures.
*Recommends corrective actions to prevent and resolve fraud or noncompliance and assists operational management in the implementation of solutions.
*As directed by the Director of Compliance, assists in the development of departmental or area compliance plans, monitors implementation and adherence to such plans.
*Serves as an additional compliance resource for HIPAA Privacy issues through cross training with other compliance personnel.
*Shares compliance learnings, finding and concepts with PHS staff at every opportunity.
*Performs other functions as required.
Three to five years experience in healthcare compliance and/or healthcare auditing and monitoring. Familiarity with Healthcare Insurance Portability and Accountability Act
* Bachelor Degree
Competencies and skills:
* SKILL-Ability to effectively interact with customers to understand their needs and explain data
* SKILL-Microsoft Office
* SKILL-Demonstrated ability to communicate effectively in person and via telephone with members, employer groups, brokers, physicians, and physician office staff using strong dialogue and customer service competencies.
* SKILL-Written communication
Benefits are effective day-one (for .45 FTE and above) and include:
- Competitive salaries
- Full medical, dental and vision insurance
- Flexible spending accounts (FSAs)
- Free wellness programs
- Paid time off (PTO)
- Retirement plans, including matching employer contributions
- Continuing education and career development opportunities
- Life insurance and short/long term disability programs
Presbyterian Healthcare Services is a locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, it is the state's largest private employer with approximately 11,000 employees.
Presbyterian's story is really the story of the remarkable people who have chosen to work here. Starting with Reverend Cooper who began our journey in 1908, the hard work of thousands of physicians, employees, board members, and other volunteers brought Presbyterian from a tiny tuberculosis sanatorium to a statewide healthcare system, serving more than 700,000 New Mexicans.
We are part of New Mexico's history - and committed to its future. That is why we will continue to work just as hard and care just as deeply to serve New Mexico for years to come.
About New Mexico
New Mexico's unique blend of Spanish, Mexican and Native American influences contribute to a culturally rich lifestyle. Add in Albuquerque's International Balloon Fiesta, Los Alamos' nuclear scientists, Roswell's visitors from outer space, and Santa Fe's artists, and you get an eclectic mix of people, places and experiences that make this state great.
Cities in New Mexico are continually ranked among the nation's best places to work and live by Forbes magazine, Kiplinger's Personal Finance, and other corporate and government relocation managers like Worldwide ERC.
New Mexico offers endless recreational opportunities to explore, and enjoy an active lifestyle. Venture off the beaten path, challenge your body in the elements, or open yourself up to the expansive sky. From hiking, golfing and biking to skiing, snowboarding and boating, it's all available among our beautiful wonders of the west.
AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.