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Company Description

Job Description

This position consists of a hybrid schedule with mandatory Monday's in office at our Linthicum location, and an additional day of the week in office as well. First few weeks would be fully on-site for training.

General Summary

Under the supervision of the Director of Compliance, the analyst will manage, develop, implement and monitor policies, procedures, processes, training, corrective action plans and overall operations to ensure compliance with federal and state laws and regulations affecting the Medical System and its Affiliates. Additionally, the Analyst will work collectively with Affiliate management and other personnel to ensure that compliance initiatives are implemented at all UMMS affiliates. For assigned components, individuals will be responsible for leading efforts implementing, monitoring and tracking Compliance Program elements and providing direction and guidance to affiliate personnel for adherence to industry regulations, system policies, Federal Sentencing Guidelines, CMS Conditions of Participation, Conditions of Payment and State specific requirements.

Principal Responsibilities and Tasks

The following statements are intended to describe the general nature and level of work being performed by the individuals assigned to this classification. These are not to be construed as an exhaustive list of all job duties performed by personnel.

Principal Responsibilities Of a Corporate Compliance Analyst Include

• Serves as case investigator and performs follow-up with affiliate personnel on complaints and inquiries received through the Compliance Hotline, internal reporting, or other reporting and monitoring mechanisms.
• Develops closing summary reports for case investigations and performs follow through to determine implementation of corrective action plans.
• Serves as a consultant to UMMS operations personnel including Affiliate Compliance Officers for compliance questions and collaborate with affiliate management personnel in the development of corrective action plans.
• Prepares reports to meet the needs of the Chief Compliance Officer, Director of Compliance, and UMMS executive management and the Audit and Compliance Committee of the Board of Directors.
• Conducts audits/reviews and performs analysis to determine compliance with applicable federal and state laws, and policies and procedures.
• Monitors data and trends to determine deficiencies and/or areas for further investigation and provides recommendations.
• Develops and implements compliance policies as requested by the Compliance Director.
• Carries out compliance research on specific topics such as Privacy regulations, Conflict of Interest Standards, Billing & Coding, policy development and healthcare regulations.

Compliance Subject-Matter Areas

Manages All Aspects In One Or More Subject-matter Areas Of Compliance Operations And Works Directly With Corporate Compliance Directors To Implement Specific Components Of The Annual Compliance Plan. Specific Compliance Subject Matter Areas Include

Compliance Administration

Hotline Triage intake, classification, investigation, remediation and incident resolution.

• Leads intake for all reported incidents into Compliance Hotline, Call Center and Email Center. Triages, assigns incident category, notifies and involves appropriate affiliate or shared service team when applicable for case investigation and resolution .
• Creates and maintains hard copy file documentation and logs into departmental tracking database.
• Manages the follow-up process for resolving incidents according to organizational policy timeframes.
• Develops Compliance Hotline statistical data for reporting to the Audit and Compliance Committee of the Board of Directors , the Executive Compliance Committee, the Affiliate Compliance Officer Committees and other meetings as requested.
• Education, both general and supplemental, development, distribution and presentation. Healthcare compliance and regulatory research.
• Analyzes, prioritizes and provides supporting research theory on researched data and summarizes in a presentable format for discussion with management.
• Prepares departmental research reports inclusive of supporting documentation and executive summaries as applicable.
• Identifies education and training needs across organization's shared services and affiliates.
• Carries out compliance special projects such as compliance internal education and training requirements, development and of training modules and loading into learning management system and annual review and revision of organizations learning portal library.
• Policy Administration and development of committee content and follow through on action items.
• Oversees standardized system for ensuring compliance policy implementation at each affiliate.
• Assists in the implementation and support of the policy and procedure management process.
• Works collaboratively with the Compliance Director in compiling agenda and materials for Audit and Compliance Committee of the Board of Directors, the Executive Compliance Committee, the Affiliate Compliance Officer Committees and other meetings as requested. Attends and take minutes as requested. Performs follow-up on meeting topic discussion when necessary.

Screening and Exclusion

• Screening and Exclusion of System Groups
• Manages the Screening and Exclusion process for all employee/staff group levels, conducting data runs from government databases, determining report matches, conducting necessary research and preparing and submitting reports to HR, Office of General Counsel and Corporate Compliance for appropriate action and resolution.
• Conducts training regarding the Screening and Exclusion process and protocols
• Develops and maintains Screening and Exclusion policies, tools and vendor process.

Qualifications

Education and Experience

• Bachelor's degree in business administration or healthcare or a relevant field required .
• Two (2) years of work experience in a business, professional or health care environment, including one year experience in Compliance, Internal Audit, Billing, Coding, Education and Training, Case Investigations, Research or equivalent related fields is required .
• Experience with data analysis tools and techniques are preferred.

Knowledge, Skills And Abilities

• Must be able to maintain confidentiality of all compliance related or other reported issues.
• PC literate with intermediate proficiency in Microsoft Office Suite, Visio, Internet and data analysis tools and techniques.
• Effective verbal, written and interpersonal skills to communicate with colleagues, patients and/or visitors to establish strong working relationships.
• Strong problem solving and decision-making skills.
• Knowledge of Medicare Reimbursement System and/ or billing and coding rules.
• Knowledge of Learning Management Systems (LMS)
• Knowledge of risk assessments and monitoring activities related to compliance risks.
• Knowledge to effectively communicate with health care providers at all levels.
• Strong analytical skills.
• Ability to work in a self-directed team by taking and giving direction and sharing in the responsibility of the team.
• Self-motivated. Able to evaluate the scope of each day's work and use time management and organizational skills to accomplish assignments.

Additional Information

All your information will be kept confidential according to EEO guidelines.