Analyst, Compliance (32122)

In the performance of their respective tasks and duties, all employees are expected to conform to the following:

• Perform quality work within deadlines with or without direct supervision.
• Interact professionally with other employees, customers, and suppliers.
• Work effectively as a team contributor on all assignments.
• Work independently while understanding the necessity for communicating and coordinating work efforts with other employees and organizations.
  
  

Position purpose

The Compliance Analyst oversees compliance and regulatory activities to ensure compliance with federal and state regulatory requirements and internal policies/procedures. The Compliance Analyst will oversee and support various elements of the compliance program, including, but not limited to, managing compliance policies and procedures, compliance training/communications initiatives, and reporting.

Responsibilities/Duties/Functions/Tasks:

Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

• Create and maintain training materials to educate the organization on compliance programs, policies and procedures, and regulatory requirements. Track completion of compliance training.
• Assist in conducting compliance assessments and remediation efforts. Track implementation of corrective actions and complete follow-up reviews.
• Support OIG and SAM exclusion screenings for employees, providers, and vendors.
• Develop or oversee regular reporting for the compliance team. Generate and distribute compliance reports to Compliance Leadership and support committees.
• Conduct periodic and regularly scheduled reviews and/or monitoring exercises to ensure compliance with regulatory requirements in the affiliated practices.
• Develop and maintain compliance policies and procedures.
• Assist with risk assessment and evaluation by conducting surveys of key stakeholders and business leaders to identify potential compliance risks.
• Assist with data entry into the Compliance incident management system.
• Maintains current knowledge of applicable health care compliance and privacy requirements and the company’s compliance and privacy policies and procedures.
• Performs other duties as assigned.
  
  

Qualifications

Education: Bachelor’s degree in healthcare management or related field preferred or compliance certification (CHC, CPHC)

Experience: Three (3) years of healthcare compliance functions or audit experience preferred.

Additional Qualifications: Knowledge and understanding in state and federal regulations relative to healthcare/hospitals/clinics.

Performance Requirements:

• Excellent communication skills, both written and verbal.
• Proficient technical (computer) skills.
• Ability to multi-task and prioritize.
• Self-motivated with initiative.
• Strong sense of ethics.
  
  

Equipment Operated: This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines.

Work Environment: This job operates in professional office environments.

Physical Requirements: While performing the duties of this job, the employee is occasionally required to stand; walk; sit; use hands to finger, handle, or feel objects, tools, or controls; reach with hands and arms; climb stairs; balance; stoop, kneel, crouch or crawl; talk or hear; and taste or smell. The employee must occasionally lift or move up to twenty-five pounds. Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.

Qualifications

Qualifications

EDUCATION: Bachelor’s Degree from a four-year College or University in Accounting or Finance or related business field and 4 or more years of relevant experience required; Master’s Degree preferred.

EXPERIENCE: Minimum of two (2) years of related experience required; healthcare experience preferred; private equity experience preferred; fundamental understanding of accrual based accounting and the impact on financials; experience or skills reconciling various financial systems

OTHER QUALIFICATION: N/A

Performance Requirements:

• Ability to effectively communicate at all personnel levels (staff person to senior management) both internally and externally based on the information required at each particular level
• Able to maintain the utmost confidentiality and discretion with respect to dissemination of information
• Detail oriented; able to keep key personnel on task regardless of their position in the organizational and target hierarchy
• Ability to understand and explain the relevance of various diligence requests from each functional area as well as be able to distinguish between and make decisions on critical ‘must have’ requirements necessary to close the deal vs. ‘nice to have’ secondary requirements
• Ability to review, comprehend and communicate how various processes internal to the targets work relative to how The Company’s processes work
• Keen sense of awareness with regard to identifying potential challenges, risk issues, inconsistencies, and opportunities
• Strong Microsoft Office, communication, presentation, and interpersonal skills
• Self starter with the ability to work independently
• Ability to multi-task and meet deadlines in a fast-paced, high pressure environment, while providing accurate, reliable, high quality work
  
  

Key Considerations / Critical Items for Various Functional Areas

• Finance – Review of financial statements and validation of revenue and expenses based on detailed reports from targets’ billing system; assess financial proforma to historical data and future expectations
• Legal – Corporate documents, insurance loss runs, review of existing contracts (including employment agreements) and leases
• Credentialing – Background checks, and receipt of hospital credentials in order to complete internal credentialing process
• Provider Enrollment – Provider numbers for various payers
• Billing – Review of targets’ current billing practices and systems
• Compliance – Audit of targets’ current documentation and coding practices
• Contracting – All major contracts comprising 85-90% of volume and revenue
• Accounting – Bank account information, payroll process, AP process
• Tax – Tax returns
• Human Resources – Current benefits compared to The Company’s, review of targets’ profit sharing plans and decisions on termination of those plans
• IT – Review of targets’ IT systems and requirements for migration to The Company’s system
• Resilience – Being able to cope and maintain emotional separation from issues
• Multi-Tasking – Capable of handling multiple requests at once
• Entrepreneurialism - Willingness to “roll up her/his sleeves” and work in a lean fast paced start-up environment
  
  

Equipment Operated: Standard office equipment including computers, fax machines, copiers, printers, telephones, etc.

Work Environment: Work requires hand dexterity for office machine operation, stooping and bending to files and supplies, mobility to complete errands, or sitting for extended periods of time. Occasionally lifting files or paper weighing up to 20 pounds. Occasionally work environment may be very stressful.

Mental/Physical Requirements: Normal office environment. May view computer screens for long periods of time. Occasional evening or weekend work.