Compliance and Privacy Specialist

Overview

The Compliance and Privacy Specialist is responsible for supporting the development, implementation and execution of the company's corporate compliance and privacy programs. This individual will support the overall functions of the compliance program (auditing, monitoring, training, policy management, investigations, risk assessments) supporting key compliance controls and the business' functional departments with specific support for activities related to privacy.Responsibilities

Assist with ensuring compliance program requirements are fulfilled, including

Supports completion of quarterly compliance reviews/audits to maintain oversight of various defined risk areas of the company and report on non conformities, adequacy and any recommendations for change

Supports completion of risk assessments, monitoring and auditing functions

Assists with compliance reporting/analytics and benchmarking

Assist with external and internal compliance, payer and regulatory audits, reviews, attestations and assessments

Assist with preparation and updates of training materials, guidance documents, compliance communications and follow up to ensure heightened awareness of the Code of Conduct; and understanding of new and existing compliance issues and related policies and procedures

Develop/revise and implement company policies, procedures and training to ensure conformance to applicable state and federal health and consumer data privacy statutes and regulations, accreditation standards and other applicable regulatory/legal requirements

Serve as a support contact for the organization related to privacy matters

Review/investigate privacy concerns including evaluation of possible breach scenarios and any necessary reporting

Respond to third party document requests and subpoenas

Monitor consumer and health data statutes and legislation for relevant updates and or new requirements

Assist with contract review and management

Assist withthe operations and oversight of the educational, charitable and research grants program

Assist with timely response to inquiries, complaints, cases, and grievances

Assist with investigating issues and suspected non conformities, reviewing records, tracking progress and and project management, supporting completion of necessary reports, summarizing and documenting issues, answering questions, and participating in other activities of the department.

May also assist in supporting the Manager, Licensing and Credentialing to ensure compliance with credentialing, licensing and various enrollment requirements for relevant government programs

Collaborate with and be a liaison to other functional departments such as Reimbursement, Marketing, Sales, Commercial Operations, Payer Relations, Regulatory and Quality to ensure activities are consistent with corporate policy, regulatory and legal requirements

Conduct research and keep abreast of regulatory changes and developments in the medical device environment, HIPAA and HITECH, breach reporting, and other legal research in support of maintaining an effective program

Support development of a supportive, inclusive and positive compliance culture

Other duties as assigned

Qualifications

Education & Experience

Required:

3+ years of experience in Legal, Compliance, Risk Management as a paralegal or compliance professional (in healthcare environment preferred)

Healthcare compliance certification (i.e. CHC, CCEP, CHPC) or other accredited regulatory compliance certification program or willingness to become certified

Preferred:

Bachelor's degree or Associate's degree

Knowledge & Skills

Thorough understanding of compliance concepts in the healthcare industry (privacy, fraud and abuse, confidentiality/protected health information, electronic security, anti-kickback, physician/clinician "sunshine" reporting and general regulatory compliance strategies)

Familiarity and understanding of:

HIPAA/HITECH

State privacy statutes (CCPA, CO Privacy Act, etc.)

False Claims Act

Anti-Kickback statute

Sunshine Act/Open Payments Reporting (and separate state statutes)

AdvaMed Code of Ethics

Ability to operate in a fast-paced environment with flexibility to prioritize, balance and respond to competing needs within the organization

Ability to multitask while maintaining strong organizational, analytical and research-oriented skills

Ability to understand and develop policies, processes and controls

Excellent oral and written communication skills

Comfortable working in situations with no clear answer

Highly effective communicator with the ability to partner cross-functionally to identify and resolve issues

Below is the starting salary range for this position, although offers may differ based on the candidate's location, job-specific knowledge, skills and experience.

$61,500 - $86,205

Additional benefits:

exempt - Our total compensation package includes medical, dental and vision benefits, retirement benefits, employee stock purchase plan, paid time off, parental leave, family medical leave, volunteer time off and additional leave programs, life insurance, disability coverage, and other life and work wellness benefits and discounts. Benefits may be subject to generally applicable eligibility, waiting period, contributions, and other requirements and conditions.