Under the Direction of the Chief of Staff, the Compliance Program Senior Manager (CPSM) establishes and implements an effective organization wide Compliance Program. The CPSM is responsible for the organization maintaining compliance with the rules and regulations of regulatory and funding agencies. The CPSM manages the organization policies and procedures program to ensure all documents are maintained, relevant, and understood by staff. The CPSM evaluates agency performance across Aviva Health compliance objectives while working closely with management staff to achieve the highest levels of performance.

ESSENTIAL FUNCTIONS:

• Monitors compliance with federal, state, and local regulatory requirements. Stays abreast of laws and regulations that might affect the organization’s policies and procedures.
• Initiates, develops, maintains, and revises policies and procedures that ensures all departments are in compliance with applicable laws and regulations as well as appropriate standards of practice consistent with the general operation of the Compliance Program and its related activities.
• Assures compliance with HIPAA, 340B program, OSHA, and any applicable Accreditation Standards.
• Manages day-to-day operations of the agency Compliance Program. Oversees the testing, auditing, and research design to prevent illegal, unethical, or improper conduct.
• Provides reports on a regular basis, and as directed or requested, keeps the Board and senior management informed of the operation and progress of compliance efforts.
• Collaborates with Medical, Dental, Accounting/Billing, and Administration departments to guide compliance activities, and assists in the development of corrective action plans.
• Identifies potential areas of agency vulnerability and risk; develops/implements risk management plans and provides general guidance on how to avoid or deal with similar situations in the future.
• Is responsible to be the Aviva Health HIPAA/Privacy Officer.
• Ensures proper communications are fulfilled to duly authorized government, regulatory, and enforcement agencies as appropriate and/or required.
• Works with the Human Resources Department and others as appropriate to develop an effective compliance training program, including appropriate introductory training for new employees as well as ongoing training for all employees and managers.
• Maintain library of Policies, Procedures, and SOPs required for external audits and reviews.
• Liaison for external audit agencies and internal functional department.
• Coordinates organizational preparation for, execution of, and follow up to Compliance audits and other external reviews.
• Coordinates with Quality Assurance and with Decision Support for Compliance documentation.
• Other duties as assigned.

QUALIFICATIONS:

• Experience: A minimum of 5 years’ experience in a healthcare organization, to include demonstrated leadership. Familiarity with health care related financial, quality assurance, and human resource procedures and regulations is a must.
• Professional certification in Healthcare Compliance required within 1 year of appointment.
• Familiar with a variety of healthcare processes, concepts, practices, and procedures.
• Strong organizational skills.
• Ability to maintain and respect strict confidentiality.
• Ability to maintain friendly, courteous, and respectful manner in all patient and staff encounters.
• Ability to prioritize and work under deadlines.

EDUCATIONAL REQUIREMENTS:

• Bachelor’s degree in Compliance or Health Care related field of study required; Master’s Degree preferred.