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Manager Compliance

Location:
Pontiac, Michigan, United States
Posted:
January 12, 2017

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RoxAnne Y. Harris, BS, MSA, CHC

***** **** ******* ****** **** Palm Beach, FL 33412 • (313) ***-**** • acx8ys@r.postjobfree.com

Niche Expert in Regulatory Compliance

Strong Management history encompassing Regulatory Compliance, and HIPAA Privacy

CAREER HISTORY

Palm Beach County Congressional Field Organizer (temp.) Palm Beach Gardens, FL August 16 – November 16

Managed all aspects of campaign duties for DCCC endorsed candidate in FL - US Congressional District 18, traditionally one of the most competitive and expensive districts in the country. After successfully winning the primary by a 30% margin, worked to cultivate relationships throughout the county to garner support for phone bank and visibility efforts and designed a loyalty campaign for the candidate across political party lines.

Accomplishments included:

Planned and executed women for Randy Perkins for Congress functions

Coordinated meetings and visibility opportunities with ministerial alliances, veterans and local official’s in two counties

Accomplish Therapy, LLC, West Palm Beach, FL June 2014-October 2016

Director of Compliance

Designed and controlled the Ethics and Compliance Program as a contract therapy provider under arrangement with 84 skilled nursing facilities in the SE Region. Recruited and trained compliance specialist with clinical and administrative skills to administer the program under the direction of the Director of Compliance. Oversaw all organizational compliance education, audits and investigations. Developed risk based program to ensure alignment with Federal and State regulatory initiatives. Collaborated with operations and education to provide a full scope effective program.

Managed the company appeals and denials to improve payer relations and claim outcomes. Prepared leadership reports for the compliance committee and senior leaders of the organization. In coordination with CEO’s operational strategies, drove the company’s reputation, identity and branding to the communities we served.

Accomplishments included:

Created and distributed quarterly compliance newsletter to over 900 staff to ensure timely compliance communications.

Created and implemented an effective marketing campaign that incorporated the Company mission and values, the compliance officer contact information and, the hotline contact information onto all staff identification badges.

Palms West & JFK North Hospitals, Loxahatchee, FL January 2012-June 2014

Ethics & Compliance Officer

Implemented, aligned and managed the corporate ethics and compliance program for two member HCA hospitals with over 500 acute and psychiatric beds. Investigated and created remedial action plans for issues involving misconduct or inappropriate behavior based on Federal, State and/or company policies. Created and presented program reports to Board of Trustees, leadership and management. Owned and leveraged community, Board of Trustee and leadership relationships to ensure depth of the program is achieved. Presented and monitored employee participation with Code of Conduct annual training based on system requirements. Key strategist in creating the ethics and compliance vision for both hospitals Routinely evaluated compliance and ethics risks by monitoring industry and corporate standards with actual employee and physician behaviors. Worked closely with the Privacy and Information Security officers concerning matters of HIPAA privacy and security violations. Served as the hospitals Good Government Group Legislative Liaison for 2013-2014.

Accomplishments included:

Analyzed complex compliance investigation data in order to generate simple risk-based trend reports with recommendations for leadership.

Improved efficiency in the compliance program by generating automated projections for high cost or high risk services that were reimbursed in excess of $500,000 in a year by Medicare.

Healthcare District Palm Beach County, Palm Springs, FL June 2011-January 2012

Chief Compliance & Privacy Officer

Served as the District’s sole compliance and privacy expert for all issues concerning adherence to federal and state regulation and District policy. Obtained counsel from Legal Affairs to ensure District, state and Federal contract requirement compliance. Oversaw compliance and operational audits to ensure the District’s adherence to regulation and; created useful corrective action plans where opportunity existed. Had complete oversight for all education and other elements of an effective compliance program. Created all compliance audits and monitoring plans and reports for District Board and senior leadership. Owned relationship with Board and senior leaders regarding all elements of the compliance and privacy programs to ensure open, consistent communication and program support to make certain that strategic goals were being met.

Accomplishments included:

Received Board approval to expand the Compliance Officer role to include Privacy to ensure the organizational structure complied with Federal and state standards and laws.

Obtained Board consent to conduct an annual compliance risk assessment.

Henry Ford Health System, Detroit, MI January 2006-April 2011

Compliance Officer

Served as Compliance Officer for a 903-bed tertiary, teaching hospital, 28 ambulatory sites and employed medical staff with over 1,100 medical staff, mid-level providers and members. Served as a primary corporate resource for fraud and abuse regulation interpretation and dissemination.

Managed online compliance education for hospital and medical group. Developed, owned and implemented corporate compliance policies and programs. Created and continued to oversee the Compliance Council (CC) to ensure it is properly staffed, aligned with system strategic goals and operated effectively. Promoted a culture of self-reporting and resolution for all compliance issues including hotline related activities. Worked closely with legal and patient financial services to resolve suspected non-compliance, misconduct and/or in appropriate billing. Served on multiple leadership councils at the will of the CEO.

Accomplishments included:

Developed a system-wide approach to conducting a thorough Compliance Effectiveness Assessment for all system hospitals and clinics based on the Federal Sentencing Guidelines for Organization (FSGO)

Had complete control and oversight for an OIG investigation with a potential overpayment of $673,000.00. Case was closed favorable to Henry Ford with no repayment to Medicare.

University of Phoenix, Michigan 2006-2012

Adjunct Professor

Facilitated Bachelor and Master’s level courses as part of the Health Service Administration Curriculum. Provided research and academic level writing guidance. Provided relationship management expertise to students. Provided student support services including, networking and resume writing recommendations.

Bon Secours Cottage Health Services, Grosse Pointe, MI 2005-2006

Corporate Responsibility Officer

Owned all aspects of program planning at the executive level including quality improvement, monitoring and oversight. Independently managed compliance program daily operations. Created, owned and implemented compliance policies including staff education. Created tools, monitored and tracked all compliance education and training. Created tools and ensured application for monitoring program effectiveness. Oversaw compliance audits to ensure best process improvement outcomes. Created frequent CEO and Board communications including quarterly board reports to ensure program buy-in and success at all levels of the organization.

Chaired the Corporate Responsibility Council (CRC) and ensured the council has proper staff/department representation and is operating effectively. Served the HR Grievance Committee as a management member.

Trinity Health, Farmington Hills, MI 2000-2005

Organizational Integrity Manager

Provided ongoing Federal policy analysis, interpretation and education. Performed audits/reviews to ensure adherence to Medicare and Medicaid laws. Coordinated the implementation and served as the Project Manager of the compliance e-learning system (CompliStar) for over four years. Served as a primary corporate resource for all Revenue Cycle issues and audits. Educated and trained staff, senior leadership, board members and physicians regarding Trinity Health and Federal policies and risk of noncompliance. Conducted HIPAA Privacy compliance audits and education. Wrote, edited an articulated compliance policies and best practice tools such as FAQs. Oversight for AlertLine©, compliance hotline reporting system. Proficient using Business Objects -decision support software application.

United Government Services, LLC, Detroit, MI 1995-1999

Regional Provider Affairs Representative

Effectively interpreted and communicated Medicare regulation and compliance guidance for the Fiscal Intermediary to the provider community. Frequently performed listener-based presentations and skillfully wrote articles for the monthly Medicare Part A newsletter. Tracked and monitored trends among providers in order to anticipate provider’s needs.

Other Relevant Civic/Political Experience, Palm Beach Gardens, FL 2014-2016

Campaign Manager

Oversaw all operations including fundraising, volunteer efforts, speaking engagements and grassroots organizing. Represented the candidate during community meetings. Prepared briefings, op-eds and social media posts to enhance candidate support and awareness.

North County Democratic Club, Palm Beach County, FL 2013-2016

President

For the last three years, I have served as club leader to liaise between city, county and state officials to communicate legislative and regulatory issues. Galvanize the precinct leaders to support and volunteer for campaigns.

I have also worked in both paid and volunteer roles for many candidate campaigns, advocacy and grassroots organizing in Florida and Michigan, at the congressional, state and local levels.

EDUCATION

BS, Health Services Administration, University of Detroit-Mercy, Detroit, MI 1993

MSA, Administration, Central Michigan University, Mt. Pleasant, MI 2004

CERTIFICATIONS AND LICENSURE

CHC, Health Care Compliance Association (HCCA), Minneapolis, MN 2000

ELHP, Executive Leadership for Healthcare Professionals, Cornell University, Ithaca, NY 2011

MEMBERSHIPS AND PROFESSIONAL AFFILIATIONS

HCCA, Health Care Compliance Association

ACHE, American College of Health Care Executives

Boards/Recognitions

Palm Beach County, FL, Office of Equal Opportunity, Board Member 2015-Present

2013 Legacy Magazine Annual Healthcare Business & Industry Leader of the Year



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