Director of Compliance & Privacy Ops - Emory Healthcare : Job Details
Director of Compliance & Privacy Ops
Emory HealthcareJob Location : Atlanta,GA, USA
Posted on :
2024-11-18T22:02:29Z
Job Description :
Overview: Be inspired. Be valued. Belong. At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of jobs, and a supportive environment that enables you to reach new heights in your career and be what you want to be. We provide:
- Comprehensive health benefits that start day 1
- Student Loan Repayment Assistance & Reimbursement Programs
- Family-focused benefits
- Wellness incentives
- Participates in the development and contributes to the achievement of established department goals and objectives, and annual work plan.
- Acts as a resource of the organization in matters of regulatory compliance and privacy.
- Coordinates compliance operations initiatives monitoring systems and processes for compliance tracking.
- Ensures the distribution of compliance education regarding policies and procedures, the code of conduct and new regulatory updates in coordination with Director of Compliance Education.
- Assists in, directs, and coordinates the Emory Healthcare Compliance Program oversight with ownership over day-to-day operations.
- Responds to requests for guidance from operating units, departments, and staff and delegates follow-up tasks to team members as appropriate.
- Determines need for review of compliance matters that are received by the EHC OCP.
- Independently provides analysis of compliance related matters and opportunities based on sound regulatory research, and by conducting periodic reviews of applicable healthcare regulations and rules.
- Knowledgeable in compliance matters including clinical activities, coding, billing, patient privacy, reimbursement, risk management, and strong familiarity with the applicable laws and regulations for hospital and physician practices.
- Directs internal investigation of patient privacy matters.
- Provides oversight of privacy reviews and investigations.
- Directs privacy breach risk analysis and notifications.
- Directs breach disclosure data to DHHS in accordance with the Privacy Rule.
- Collaborates with Emory University Office of General Counsel and outside counsel as needed.
- Drafts and finalizes policies related to privacy and compliance operations.
- Directs investigations in response to the Office for Civil Rights (OCR) inquiries and investigations.
- Facilitates document request between Office for Civil Rights (OCR) and Emory University Legal Counsel.
- Directs review of Business Associate Agreements and questions, and document revision.
- Independently or collaboratively conducts investigations, summarizes results, and makes recommendations when indicated by audit results.
- Working with Internal Audit and Enterprise Risk Management to execute the Annual Enterprise Risk Assessment.
- Partners with Operational leadership as appropriate on the implementation of policy and procedures as well as education of departments deemed to have need in relation to compliance and privacy issues.
- Assists Patient Relations and the Risk Management departments with patient letters and communications around HIPAA/Privacy allegations.
- Works with the Director, Compliance Coding and Billing Audit and Analysis on billing reviews and refunds.
- Develops/reviews and updates policy & procedures as needed or requested.
- Works with CCO EHC across various compliance and privacy matters.
- May work independently or at the direction of the CCO EHC.
- Manages or leads advanced investigations to include submission of findings, complying with notification requirements, and works with the operating unit/HR on potential corrective actions.
- Monitors, assesses, and prioritizes key compliance risk areas and proactively works to identify major enterprise-wide compliance risks.
- Leads compliance investigations on alleged violations of rules, regulations, Code of Conduct, and policies; evaluates and recommends investigations, as appropriate.
- Coordinates the resolution of compliance investigations.
- Maintains strong awareness of federal and state laws, regulations, guidelines and Federal Health Care Program payment and reimbursement requirements, False Claims Act and changes that may affect the organization.
- Participates actively in developing and implementing ethical business practices.
- Provides oversight of compliance activities and real-time guidance related to compliance issues to business units across EHC.
- Directs the coordination and completion of government and regulatory requests for documents.
- Manages large scale compliance projects and initiatives to completion.
- Interacts with other department leaders.
- Other duties as circumstances and events warrant (e.g., special projects etc.).
- Assists in drafting Management Compliance Committee (MCC) and Audit & Compliance Committee (ACC) meeting materials and reports.
- Provides oversight of compliance activities and real-time guidance related to compliance issues.
- Reviews and provides guidance on Conflict of Interest (COI) and Conflict of Commitment (COC).
- Coordinates documentation of management action plans for identified COI/COC and drafts materials for review by COI Management Committee.
- Provide guidance for workforce members in relation to anticipated vendor relations.
- Facilitates EHC annual COI disclosure Emory entities. Reviews annual disclosure statements to identify potential COI concerns reported by workforce members.
- Conducts COI investigations and develops reports/data analysis to provide to leadership.
- Review and update COI policy periodically.
- Coordinates the Emory Trust Line (Hotline) and ensures that concerns have been addressed through effective follow-up in accordance with policies and procedures.
- Runs reports as requested by leadership.
- Coordinates distribution of reported concerns to appropriate operating unit as needed.
- Promotes use of the Emory Trust Line and develops campaigns for employee awareness of platform.
- Coordinates with Emory/EHC HR on matters as needed.
- Coordinates with EU Compliance on matters as needed.
- Partners with Risk Management for awareness of SAFE reports that may have privacy and/or compliance violations and have a need for education.
- A bachelor's degree in healthcare or business-related field. Master's degree preferred.
- Seven (7) years experience working in the healthcare compliance environment with preference in an Academic Medical Center.
- Experience in conducting investigations, performance of compliance audits and reviews, in-depth knowledge of healthcare compliance and privacy laws, regulations, and guidance.
- Strong written and oral communication skills.
- Strong analytical and problem-solving skills.
- Proficiency in working with Microsoft Office products and other healthcare applications.
- Proven ability to manage multiple projects and deadlines. Strong people management skills.
- May be required to travel to various operating units locations.
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