13 days old

VBC Compliance Manager

Conifer Health Solutions
Ventura, CA 93001

As a part of the Tenet and Catholic Health Initiatives family, Conifer Health brings 30 years of healthcare industry expertise to clients in more than 135 local regions nationwide. We help our clients strengthen their financial and clinical performance, serve their communities and succeed at the business of healthcare. Conifer Health helps organizations transition from volume to value-based care, enhance the consumer and patient healthcare experience and improve quality, cost and access to healthcare. Are you ready to be part of our solutions? Welcome to the company that gives you the resources and incentives to redefine healthcare services, with a competitive benefits package and leadership to take your career to the next step!

JOB SUMMARY

The Compliance Manager contributes to Conifer Health s (Conifer) purpose by providing day-to-day leadership to the compliance program designed to ensure Conifer fully complies with its Standards of Conduct and all applicable laws and regulations. The Compliance Manager supports his/her respective area(s) of Conifer s Ethics and Compliance program which may include, but not be limited to: Regulatory Change Management, Vendor Oversight, and Compliance Operations.

Develops, implements, and oversees core elements of the ethics and compliance program; including (1) maintaining and expanding visibility of the compliance program at all levels within the organization and (2) ensuring there is an effective compliance program and oversight in place to remain compliant with all applicable local, state, federal,and international rules, regulations and adimistrative requirements.

ESSENTIAL DUTIES AND RESPONSIBILITIES

Include the following. Others may be assigned.

Vendor Oversight:

Drives compliance performance and outcomes utilizing and optimizing the current Vendor Qualification Program (VQP);

In partnership with contracting and operational leaders, establishes routine vendor oversight meetings to review contractual requirements, reports and performance;

Develops and enhances a detailed risk rating process for all vendors to establish appropriate monitoring and oversight activities;

Utlizes appropriate technology to enhance tracking/reporting for all Vendor Oversight Program activities;

Partners with Compliance SMEs to monitor vendor compliance including all CAPs;

Assists in the Annual Ethics and Compliance Risk Assessment and development of the Annual Ethics and Compliance Work Plan for the Vendor Oversight Program;

Formulates routine and non-routine Vendor Oversight Program reporting capabilities including vendor dashboards for organizational leadership;

Assists with the review and validation of the vendor OIG/GSA exclusion checks;

Performing vendor audits/reviews and reporting findings to leadership including development of formalized CAPs and adjustment to vendor risk rating;

Develops and maintains a vendor-focused compliance training program.

Regulatory Change Management:

In conjuction with internal business partners (e.g.,Legal and Operations) optimizes and maintains a comprehensive regulatory change management process by:

oEvaluating and selecting an appropriate technology solution

oConfiguring the technology solution to provide actionable reporting and workflow functionality

oLeveraging key stakeholders within shared services and operations to ensure an effective program

oDeveloping communication protocols to ensure appropriate parties are aware of critical changes to regulations

oDefining and executing a monitoring strategy to continuially assess process effectiveness

Compliance Operations:

Participates in and contributes to the development of the Annual Compliance Work Plan and related documents.

Conducts ongoing compliance work plan reviews for purposes of identifying, assessing, and documenting potential compliance violations of the Standards of Conduct and policies and applicable local, state, federal, and international healthcare rules, regulations and administrative requirements; implements corrective action plans (CAPs) as required.

Reduces organization risk by identifying compliance risks and by developing and managing key work plan activities to address identified risks.

Identifies and assists in the implementation of educational opportunities that stress the importance of a strong culture of compliance to all Conifer team members and contractors.

Manages the organizational OIG/GSA exclusion screening process

In collaboration with compliance and operational leadership, develops and/or oversees compliance policies and procedures.

Partners and collaborates with leadership and business partners to communicate and integrate the compliance program throughout the organization.

Provides ongoing compliance-related support to team members and key decision makers

Serves as an internal expert and advisor in compliance matters

Collaborates with key leadership, team members, contractors and other stakeholders throughout Conifer to promote a culture of compliance.

SUPERVISORY RESPONSIBILITIES

If direct report positions are listed below, the following responsibilities will be performed in accordance with guidelines, policies and procedures and applicable laws. Supervisory responsibilities include interviewing, hiring, and training employees; planning, assigning and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems.

Direct Reports (titles) Specialist, Analyst, Sr. Specialist, and/or Sr. Analyst as applicable




Qualifications:

KNOWLEDGE, SKILLS, ABILITIES

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 individuals with disabilities to perform the essential functions.

  • Ability to work independently with little supervision and seek guidance as needed to clarify assignments or request for information.
  • Excellent communication, customer service and time-management skills
  • Possess basic business skills, an understanding of general compliance operations and department goals in the healthcare environment.
  • Proficient with various desktop applications such as Microsoft Excel, Word, PowerPoint and/or Access.
  • Intermediate knowledge of relational database management systems
  • Must be a team player - Always willing to help in whatever way possible and go the extra mile to get the job done.
  • Intuitive and skilled at problem solving in anticipation of customer request
  • Have the ability to make logical correlations between data points to determine if analysis is accurate
  • Detail oriented, meticulous and accurate in completing tasks on time.

    EDUCATION / EXPERIENCE

    Include minimum education, technical training, and/or experience preferred to perform the job.

    • Bachelors Degree in Business, Information Systems, Health Care Administration or related field or equivalent years of related Analyst experience required.

      REQUIRED CERTIFICATIONS/LICENSURE

      Include minimum certification required to perform the job.

      • Project Management Professional (PMP) is preferred

      • Certified Healthcare Compliance (CHC) is preferred

        PHYSICAL 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.

        • Must be able to work in sitting position, use computer and answer telephone

          WORK ENVIRONMENT

          The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

          • Office Work Environment


            Job: Managers and Directors
            Primary Location: Encino, California
            Posted: 2019-09-04 Expires: 2019-10-06

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VBC Compliance Manager

Conifer Health Solutions
Ventura, CA 93001

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