Senior Compliance Analyst

Position Responsibilities may include, but not limited to

• Regularly review State and Federal laws, rules, in partnership with legal and notify internal business partners of applicable changes to ensure organizational compliance is maintained
• Complete a regular review of policies and procedures to maintain alignment with state and federal compliance regulations; recommend updates, work with leadership to complete
• Ensure resolution of Critical Incidents with appropriate internal business partners and notify agency caseworkers/contacts according to contractual and regulatory obligations
• Investigate and ensure resolution to Grievances received from clients, agencies, and third parties; provide any required follow-up education to employees or leaders; collaborate with leadership to determine and implement corrective actions
• Compile compliance metrics and analyzes results for ongoing tracking and Board and Executive review
• Manage general compliance email as needed
• Execute regular Compliance Program Self-Assessments based on the Department of Justice recommendations; propose internal action plans to strengthen Compliance posture within organization
• Provide employee compliance education including onboarding, annual training, both departmental-specific and role-based training; participates in annual education review and as rules and regulations change; develops Compliance Tips for general education
• Assist in development of compliance audit program by planning and conducting second line of defense compliance audits; communicate results to applicable internal business
• Review and investigate impermissible use/disclosure reports; provides employee re-education
• Participate in breach notification process
• Develop and provide employee privacy education including onboarding, annual training, both departmental-specific and role-based training; participate in annual review education review or as rules and regulations change; Privacy Tips for general education
• Assist in development and oversee HIPAA Auditing/Monitoring Plan and annual revision; privacy aspects of HITRUST; monitoring of program using OCR Audit Protocol
• Act as an internal compliance/privacy resource for Mom’s Meals employees
• Engage in ongoing education and professional development to increase compliance expertise, business acumen, and regulatory knowledge
• Collaborate with teammates, leadership team, and internal business partners to produce effective compliance and privacy program outcomes
• Manage all external audit activity, including: audit intake, analysis, information/document requests from internal business partners, review and preparation, submission, auditor meetings, results review and response
• Draft Corrective Action Plans (CAP) and Audit Appeals with input from applicable internal business leaders and Compliance Leadership in response to audit findings
• Identify, track, and trend in auditing to ensure proactive preparation for future audits and/or determinations resulting in CAPs
• Maintain electronic audit resource library to ensure up-to-date documentation
• Maintain external audit tracking database to house all audit activity and status and supports reporting and data analytics of audit data

Required Skills and Experience

• Bachelor’s degree OR 8 years relevant experience
• 4-7 years’ experience in auditing, payer relations, compliance, privacy, information security or other relevant healthcare industry experience
• Strong problem-solving skills including attention to detail
• Ability to prioritize (and re-prioritize) projects in a fast-paced work environment
• Effective written and verbal communication skills
• Ability to work collaboratively to foster trust, credibility, and understanding
• Ability to promote teamwork within department and organization
• Exceptional personal organizational skills to meet deadlines, complete work assignments and projects and/or accomplish time sensitive work prior to due dates
• Maintain working knowledge and understanding of various state/federal compliance and privacy laws, rules and regulations related to Medicare/Medicare Advantage plans, Medicaid, Managed Care Organizations
• Proficient in Microsoft Office Applications including Word, Excel, PowerPoint, and Outlook

Preferred Skills and Experience

• Certification in compliance, privacy or other relevant area 

Physical Requirements

• Repetitive motions that include the wrists, hands and/or fingers
• Sedentary work that primarily involves sitting, remaining in a stationary position for prolonged periods
• Visual perception to perform job including peripheral vision, depth perception, and the ability to adjust focus