REPORTS TO: Executive Director WORK WEEK: Expectation of 40 hours per week WAGE CLASSIFICATION: Exempt OSHA RISK CLASSIFICATION: Low SUMMARY POSITION STATEMENT This position is has principal authority and responsibility for the development, implementation, oversight and evaluation of all aspects of Peninsula Community Health Services Compliance Program. ESSENTIAL FUNCTIONS/ROLES " RESPONSIBILITIES OF THE POSITION Authority. The Compliance Officer is authorized to investigate all instances of suspected illegal or unethical conduct and may, upon obtaining appropriate authorization, and consistent with PCHS budget constraints, seek the advice of qualified legal counsel and hire outside investigators and/or consultants. In holding such authority, the Compliance Officer is assured direct access to PCHS ’s ED and, together with the ED, to PCHS ’s Board of Directors —unless the matter involves PCHS ’s ED, in which case the Compliance Officer may report independently to the Board of Directors —and to qualified legal counsel, in accordance with PCHS ’s Policy and Procedure for the purpose of making reports and recommendations on compliance matters.
Reporting. The Compliance Officer will be a member of PCHS ’s senior management and will report directly to the ED, who will oversee the individual ’s performance as the Compliance Officer, which may include meeting certain professional goals and objectives; recruiting, supervising, and mentoring subordinates; demonstrating and encouraging leadership; and/or maintaining good judgment and discretion in carrying out the duties of the Compliance Officer. Duties. The Compliance Officer will have all of the duties and responsibilities that are ordinarily delegated to Compliance Officers.
As part of these duties and responsibilities, the Compliance Officer is responsible for the following Compliance Program activities on behalf of PCHS: Overseeing and monitoring the development and implementation of PCHS ’s Compliance Program; Directing methods to improve PCHS ’s efficiency and quality of services and to reduce Health Center ’s vulnerability to fraud and abuse, such as conducting periodic audits, developing effective lines of communication on compliance issues, and preparing, maintaining, implementing, and disseminating written practice standards and procedures; Performs other duties as assigned. Periodically revising the Compliance Program, or recommending such revisions, in light of changes in the needs of PCHS or changes in the law and/or in the standards and procedures of government and private payor health plans; Developing, coordinating, and participating in training programs that focus on the components of the Compliance Program and seek to ensure that all PCHS Board members, as well as employees, contractors, agents, consultants, volunteers, and others who act on PCHS ’s behalf ( “Staff ”) are knowledgeable of, and comply with, pertinent Federal and State standards and the requirements of PCHS ’s Compliance Program; Ensuring that the Department of Health and Human Services, Office of Inspector General ’s List of Excluded Individuals and Entities, and the General Services Administration ’s Excluded Parties List System have been checked with respect to all Board members and Staff, as well as all applicants for Board or Staff membership; Investigating, independently or with qualified legal counsel, and acting on any report or allegation of unethical or improper conduct or business practices, and implementing and monitoring appropriate corrective action and/or subsequent compliance; Directing the implementation of corrective actions in response to reports or findings of potential non-compliance, including conferring with the Human Resources Director and/or the Executive Director regarding the enforcement of disciplinary action; and Reporting information on the activities of the Compliance Program to the Executive Director and Board of Directors / Compliance Committee of the Board on a quarterly basis. Compliance. This position requires compliance with PCHS ’s written standards, including its Standards of Conduct and policies and procedures ( “Written Standards ”).
Such compliance will be an element considered as part of the Compliance Officer ’s regular performance evaluation. Failure to comply with PCHS ’s Written Standards, which may include the failure to report any conduct or event that potentially violates legal or compliance requirements or Health Center ’s Written Standards, will be met by the enforcement of disciplinary action, up to and including possible termination, in accordance with PCHS ’s Compliance Program Policy and Procedure: Addressing Instances of Non-Compliance Through Appropriate Disciplinary Actions. LEGAL CONCEPTS Maintain confidentiality. Follow federal, state and local legal guidelines.
Maintain HIPAA compliance. POSITION REQUIREMENTS Education: Bachelor ’s degree in law, health sciences, or related field. License: Paralegal preferred. Experience: Minimum 4 years experience in health care compliance preferred.
Job Requirements: Ability to effectively communicate, verbally and in writing, with all levels of staff. Ability to maintain strict confidentiality with medical information, as well as other confidential information and conform to HIPAA regulations. Ability to carry out supervisory responsibilities in accordance with PCHS ’s policies and procedures and applicable laws. Ability to work both independently and as a team, with frequent interruptions, occasional public contact, and occasional crisis situations.
Must possess strong problem-solving skills and effective time management skills. Must have strong understanding of fiscal, administrative and clinical systems. Positive work ethic and attitude. Must pass State-required background and pre-hire drug screen.
CORE VALUES Treat all co-workers and clients with dignity and respect. Project a professional manner and image. Adhere to ethical principles. Communicate professionally " effectively – focus on cooperation and win/win outcomes.
Serve as Community Liaison. Follow and enforce the mission of PCHS. Abide by the policies and procedures outlined by PCHS including the Employee Manual. Responsible to report any safety and/or health concerns to management as soon as they become apparent.
Regular and timely attendance. Ability to bring your best work to PCHS. TYPICAL PHYSICAL DEMANDS: Occasional bending, stooping and stretching Requires eye-hand coordination and manual dexterity sufficient to operate a keyboard. Requires normal range of hearing and eyesight to record, prepare and communicate appropriate documents and papers.
Requires occasional lifting papers or boxes up to 25 pounds. JOB RELATIONSHIPS: Works closely with all service line managers, Director of Operations, and Finance Department personnel. ***PLEASE TAKE NOTE OF THE FOLLOWING APPLICANT°S STATEMENT TO WHICH YOU ARE AGREEING TO WHEN YOU SUBMIT YOUR APPLICATION *** I understand that the employer follows an quotat will employmentquot policy, in that I or the employer may terminate my employment at any time, for any reason consistent with applicable state or federal law. I understand that this application is not a contract of employment.
I understand that federal law prohibits the employment of unauthorized aliens; all persons hired must submit satisfactory proof of employment authorization and identity; failure to submit such proof will result in denial of employment. I understand this application will be active for a period of one year; after that time, if I wish to be considered for employment, I must submit a new application. I voluntarily authorize any present or former employer, firm, school, hospital, university, or government agency and its employees or agents to release any and all information concerning my former position to any prospective employer, or its employees or agents, making a request for such information. I understand that the information may include, but is not necessarily limited to, performance reports, transcripts, job descriptions, disciplinary reports and opinions regarding my suitability for the position.
I voluntarily release and hold harmless former employers, schools, hospitals or government agencies, and their employees or agents from any and all claims, liabilities, or damages arising from the disclosure or release of information or opinions concerning my professional qualifications. I certify that all the statements herein are true and correct to the best of my knowledge and understand that any falsification or willful omission shall be sufficient cause for dismissal or refusal of employment.