We've made a lot of progress since opening the doors in 1942, but one thing has never changed - our commitment to serve, heal, lead, educate, and innovate. We believe that every award earned, every record broken and every patient helped is because of the dedicated employees who fill our hallways.

At Ochsner, whether you work with patients every day or support those who do, you are making a difference and that matters. Come make a difference at Ochsner Health and discover your future today!

This job assists with maintaining an effective auditing and compliance program. Independently completes assignments, manages projects, performs research, audits, and regulatory consultations, and ensures assignment objectives are achieved. Ensures that projects, coverage and services are completed as defined for areas of responsibility in the department’s annual plan and meet the needs of the Audit & Oversight Committee of the Board of Directors and executive management. Presents conclusions to department and organization management and educates and assists employees in applying and improving overall compliance and leads any assisting staff assigned to their projects.

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential duties.

This job description is a summary of the primary duties and responsibilities of the job and position. It is not intended to be a comprehensive or all-inclusive listing of duties and responsibilities. Contents are subject to change at the company's discretion.

Education

Required – Bachelor’s degree

Preferred – Advanced degree in related field

Work Experience

Required – 4 years of Medicare Advantage experience

Preferred – Experience with healthcare corporate compliance issues

Certifications

Preferred – CHC, CHPC, CHRC, or CPC

Knowledge Skills and Abilities (KSAs)

• Must have computer skills and dexterity required for data entry and retrieval of information.
• Effective verbal and written communication skills and the ability to present information clearly and professionally.
• Must be proficient with Windows-style applications, various software packages specific to role and keyboard.
• Strong interpersonal skills to interact with individuals of diverse cultural backgrounds, of all ages, and at all levels within and outside the organization in a positive, effective manner.
• Leadership and coaching skills; team-building abilities.
• Good organizational and prioritization skills.
• Skills to work under minimal supervision in accomplishing assigned responsibilities.
• Solid knowledge of special knowledge area and internal control structures (which includes compliance with applicable laws and regulations), business risk, effective risk management techniques and auditing, and compliance's role in corporate governance and it’s key relationships with the audit committee, board, and executive and operating management.
• Skills to translate internal control objectives and complex laws and regulations into easily understood concepts, apply those concepts to a function or process, and teach/instruct others on these matters.
• Skills to gather information and understand problems, seeking out cause-and-effect relationships that identify underlying issues or problems which includes intermediate knowledge of interviewing skills and reading and comprehending complex documents.
• Skills to function with the highest sense of integrity, exercising unprejudiced and unbiased judgment on behalf of the company's welfare.
• Ability to travel regionally to various sites.

Job Duties

• Supports efforts to maintain an effective Compliance Program by ensuring that all project planning, performance, documentation, follow-up and organization is conducted in accordance with department standards.
• Collaborates on projects and resolving potential compliance issues with other departments (Operations, HR, Legal) as appropriate.
• Effectively and timely communicates with key stakeholders about projects to resolve issues and achieve desired corrective action.
• Provides in-services and other educational services to organization, management, and employees regarding risks, controls and compliance-related matters.
• Maintains technical compliance regulatory knowledge and supports solutions for the organization, management, and employees.
• Pursues self-development in accordance with an annual training plan developed with management, which is comprised of internal, external and self-administered curriculum, as well as regular reading of applicable journals, periodicals and publications.
• Other related duties as required.
  

The above statements describe the general nature and level of work only. They are not an exhaustive list of all required responsibilities, duties, and skills. Other duties may be added, or this description amended at any time.

Remains knowledgeable on current federal, state and local laws, accreditation standards or regulatory agency requirements that apply to the assigned area of responsibility and ensures compliance with all such laws, regulations and standards.

This employer maintains and complies with its Compliance & Privacy Program and Standards of Conduct, including the immediate reporting of any known or suspected unethical or questionable behaviors or conduct; patient/employee safety, patient privacy, and/or other compliance-related concerns.

The employer is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, or disability status.

Physical and Environmental Demands
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Medium Work - Exerting 20 to 50 pounds of force occasionally, and/or 10 to 25 pounds of force frequently, and/or greater than negligible up to 10 pounds of force constantly to move objects. (Constantly: activity or condition exists 2/3 or more of the time) to move objects. Physical demand requirements are in excess of those for Sedentary Work. Even though the weight lifted may be only a negligible amount, a job should be rated Light Work: (1) when it requires walking or standing to a significant degree; or (2) when it requires sitting most of the time but entails pushing and/or pulling of arm or leg controls; and/or (3) when the job requires working at a production rate pace entailing the constant pushing and/or pulling of materials even though the weight of those materials is negligible. NOTE: The constant stress and strain of maintaining a production rate pace, especially in an industrial setting, can be and is physically demanding of a worker even though the amount of force exerted is negligible.

Mechanical lifting devices (carts, dollies, etc.) or team lifts should be utilized.
Must be able to stoop, bend, reach and grab with arms and hands, manual dexterity.
Must be able to sit and stand for prolonged periods of time.
Must be able to travel throughout and between facilities.

Normal routine involves no exposure to blood, body fluid or tissue and as part of their employment, incumbents are not called upon to perform or assist in emergency care or first aid.

There is no occupational risk for exposure to communicable diseases.

Because the incumbent works within a healthcare setting, there may be occupational risk for exposure to hazardous medications or hazardous waste within the environment through receipt, transport, storage, preparation, dispensing, administration, cleaning and/or disposal of contaminated waste. The risk level of exposure may increase depending on the essential job duties of the role.

Are you ready to make a difference? Apply Today!

Ochsner Health does not consider an individual an applicant until they have formally applied to the open position on this careers website.

Individuals who reside in and will work from the state of Colorado are not eligible for remote work position .

Ochsner Health endeavors to make our site accessible to all users. If you would like to contact us regarding the accessibility of our website, or if you need an accommodation to complete the application process, please contact our HR Employee Solution Center at 504-842-4748 (select option 1) or careers@ochsner.org . This contact information is for accommodation requests only and cannot be used to inquire about the status of applications.