Senior Compliance Specialist

  • Oakland, CA
  • Legal and Compliance
  • Internal Audit & Compliance
  • Full Time - Day
  • Req #: 29992-20312
  • FTE: 1
  • Posted: July 21, 2021
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Summary

Role Overview

As the Senior Compliance Specialist for Alameda Health System, you will support the Compliance Program and HIPAA Privacy Program for Alameda Health System (AHS).  You will plan and conduct neutral, fact-finding investigations of complaints alleging violations of federal and state guidelines and AHS policy and procedures in the workplace. You will perform reviews to assess compliance based on Federal and State requirements for hospitals and clinics. Using the information found you will develop summary reports and perform follow through to determine implementation of corrective action plans and provides education as needed.

Duties & Essential Functions
Following are the duties performed by employees in this classification. However, employees may perform other related duties at an equivalent level. Not all duties listed are necessarily performed by each individual in the classification. 

  • Provides research expertise and guidance related to complex laws and regulations, including conflicts of interest, fraud, waste and abuse, CMS compliance requirements and OIG advisory guidance.
  • Serves as case investigator to work with AHS workforce on compliance and privacy allegations received through the Compliance Hotline or other reporting and monitoring mechanisms.
  • Performs any necessary follow up related to investigations, mitigation, sanctions and other corrective action with the appropriate department workforce members.
  • Assists in the development of document-specific quality control checklists, departmental processes, and SOPs.
  • Monitors trends to determine deficiencies and/or areas for further investigation and provides recommendations.
  • Coordinates and compiles documents for audit requests, including medical records, charge documents, and any other documents necessary to complete requests.
  • Performs routine and targeted audits and monitoring reviews to identify trends in potential compliance and privacy risks and recommends corrective action plans as necessary.  
  • Assists with the development of risk assessments and breach notifications and within regulatory timeframes.
  • Provides education and training to increase and strengthen AHS workforce awareness and understanding on a variety of compliance and privacy related topics. 
  • Develops and disseminates various training materials, including reference guides, cheat sheets, handouts and advisories. 
  • Works with large amounts of data by running reports from various databases in order to identify trends and gaps.
  • Create compliance and privacy benchmarking dashboards, including key performance indicator (KPI) to measure performance over time for a Compliance and HIPAA Privacy program.
  • Creates graphical presentations to present information.
  • Assists in revision and creation of policies needed to support compliance and privacy practices at AHS. 
  • Works on special compliance and privacy projects and any other required support work as assigned.
  • Performs other duties as required.

Qualifications

Required Education: BA/BS degree in business administration, healthcare, or a relevant field. 

Required Experience: Five years’ experience in a health care environment, preferably in a hospital setting, including three years’ experience with compliance and privacy concepts and practices.

Preferred License/Certification: Certified in Healthcare Compliance (CHC) and/or Certified in Healthcare Privacy Compliance (CHPC).

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