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Medical Manager

Location:
Lanham, MD
Salary:
165000
Posted:
April 11, 2021

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Resume:

Lisa D. Norris

Lanham, MD ***** H: 240-***-**** M: 202-***-****

adllvj@r.postjobfree.com

Chief Compliance Officer, Privacy Officer & Risk Manager

Lead rigorous compliance programs to meet federal, state, and local regulations governing healthcare organizations.

Accomplished professional with expertise in developing strategy, policies, procedures, and audit plans to ensure adherence to all regulatory requirements and accreditation standards. Interpret current and pending legislation, agency directives, and rules to implement necessary changes to prevent violations. Build consensus and create a culture of compliance at all levels through internal communications and trainings to increase awareness of expectations and responsibilities. Establish reporting and tracking mechanism for distribution to managers, board members, regulatory bodies, and other stakeholders.

Highlights of Expertise

HRSA & 340B Compliance

Regulatory Compliance Programs

CMS, HIPAA, OCR, OSHA, PHI/PII

Joint Commission & CARF Accreditation

Credentialing & Licensing Requirements

Risk Assessment & Corrective Actions

Strategy Development & Execution

Policy & Procedure Implementation

Internal & External Reporting

Employee Compliance & Ethics Training

Incident & Complaint Investigations

Career Experience

Mary’s Center, Washington, DC

Hired to build, implement, and enforce the corporate compliance program to meet HRSA, grant, federal, state, and local regulatory requirements.

CHIEF COMPLIANCE OFFICER (January 2020 to Present)

Oversees and monitors the development and implementation of the Compliance Program through the establishment of a Compliance Plan, policies and procedures (including the Standards of Conduct) and an annual compliance work plan

• Identifies high-risk areas through risk assessments and other means

• Identifies methods to reduce vulnerability to fraud and abuse, such as conducting periodic audits, developing effective lines of communication on compliance issues, and preparing written standards and procedures

• Periodically revises the Compliance Program and compliance policies and procedures in light of changes in the needs of the organization, changes in the law and/or in the standards and procedures of government and private payor

health plans

• Suggests, creates and implements policies and procedures related to compliance risk areas or requirements, with appropriate oversight and support from the Board and other members of the Executive Management Team

• Develops, coordinates, and participates in a training program that focuses on the components of the Compliance Program and seeks to ensure that all individuals affiliated with Mary’s Center (i.e., board members, employees, contractors, vendors, agents, and volunteers) are knowledgeable of, and comply with, pertinent federal and state standards and Compliance Program, including the Compliance Plan, policies and procedures (including the Standards of Conduct)

• Coordinates with various departments (Human Resources, Administration) to ensure that the HHS OIG’s List of Excluded Individuals and Entities, the General Services Administration’s (GSA’s) System for Award Management, and the

[state/District exclusion lists, if applicable] have been checked with respect to all individuals affiliated with Mary’s Center

• Receives incident reports or allegations of unethical or improper conduct or business practices, and responds to such reports, including conducting investigations independently or in coordination with qualified legal counsel, or by delegating theresponsibility for conducting an investigation to other staff or to a qualified third party, and implementing and monitoring appropriate corrective action and subsequent compliance

• Coordinates with Human Resources to ensure the consistent and fair application of disciplinary action, when applicable

Oversee and audit TPA 340B internal and contract pharmacy responsibilities which include, conducting internal audits, documentation management, drug inventory tracking and payment processing.

• Reports information on the activities of the Compliance Program to the CEO on a regular basis

• Reports information on the activities of the Compliance Program to the full Board of Directors at least annually and to the Compliance/Risk Management Committee of the Board monthly. More frequent reporting to the full Board of Directors and/or to the Compliance/Risk Management Committee of the Board may be required

The Retina Group of Washington, Greenbelt, MD

Hired to develop, implement, enforce, and refine compliance program to meet HIPAA, OSHA, CMS, PHI/PII, 401(k) (PSP & Defined Benefit Plans), and other federal, state, and local regulations.

DIRECTOR OF COMPLIANCE (September 2013 to January 2020)

Oversee Compliance and Medical Records Department, including financial and operational management of incoming medical records payments, as well as responses to attorney requests for medical records and subpoenas. Prepare and disseminate Annual Compliance Plan, Code of Contact, Privacy Notice, Business Associate Agreements, patient dismissal letters, patient & employee incident reports, and other compliance, medical records, privacy, and OSHA policies, procedures, manuals, and trainings. Investigate and respond to internal and external compliance, HIPAA violations, and other privacy breaches. Monitor third-party hiring to ensure completion of administrative and legal formalities, as well as compliance with standard procedures.

Spearheaded development and implementation of entire compliance program with 41 policies to-date, Workplace Safety Program, and Hepatitis B screening initiative.

Continuously monitored and interpreted CMS, OCR, legislative, and other regulatory and legal changes, advised on policy and procedure changes, and drove implementation, communication, and training.

Devised and facilitated comprehensive and effective compliance training program encompassing new hire training and ongoing annual refreshers for all staff and board members.

Ensured transparent reporting of compliance and risk management issues by providing status updates and scorecards to Board of Directors, senior managers, committees, and other stakeholders.

Boosted efficiency and effectiveness by optimizing utilization of staff and technology, including evaluating and selecting new technology to streamline workflows.

Directed internal, external, and chart audits and drove improvements to audit readiness by creating database to track real-time scorecards and reports.

St. John’s Community Services, Washington, DC

Led day-to-day operations of Corporate Compliance Program, Risk Management Plan & Program, and communication, reporting, support, and training for cross-functional departments and state subsidiaries.

COMPLIANCE MANAGER (March 2012 to August 2013)

Established, revised, and disseminated policies and trainings to prevent illegal, unethical, and improper conduct. Advised internal staff and subsidiaries on complying with all requirements, as well as using state oversight systems. Collaborated on implementation of annual CARF reviews and state subsidiary audits. Prepared quarterly compliance and risk management reports for senior managers and Board of Trustees Corporate Compliance Committee. Led and supported investigations into alleged violations of rules, regulations, policies, procedures, and Code of Conduct.

Liaised with home office staff and subsidiaries to build and maintain robust library of relevant federal and state regulatory, licensure, billing, and accreditation standards and requirements.

Facilitated education and training on Compliance Hotline, Code of Conduct, and new and existing compliance matters, policies, and procedures, including new hire training and refreshers.

Aria Health, Philadelphia, PA

Managed hospital-wide compliance with Joint Commission, CMS, and Pennsylvania Department of Health regulations, policies, and mandates.

COORDINATOR OF REGULATORY AFFAIRS (January 2011 to February 2012)

Oversaw implementation of related policies, procedures, Regulatory Affairs committee matters, and Performance Improvement processes. Tracked and monitored accreditation, Life Safety, and Joint Commission surveys, documentation, and follow-ups. Investigated, responded to, and addressed all patient-related complaints and grievances. Ensured hospital remained survey ready at all times. Devised employee training modules and conducted group and one-on-one instruction on compliance matters.

Improved reporting and communication by developing templates, databases, dashboards, scorecards, and metrics, recording regulatory minutes, and distributing PDSA, WWWH, and SWOT reports to senior managers.

Created new iPad forms and applications, presented on iPad technology at national conferences, and performed troubleshooting and technical support for iPads and data collection systems.

University of Medicine and Dentistry of New Jersey (UMDNJ, now part of Rutgers University), Somerset, NJ

Led implementation Ethics and Compliance Program initiatives across the organization and guided medical and academic community in responding to ethical dilemmas.

ETHICS SPECIALIST & ALTERNATE ETHICS LIAISON OFFICER (July 2008 to January 2011)

Maintained all documentation, communications, and filings, including Code of Conduct Attestations, CIA mandatory training, and Contractual Agreements with interested parties and vendors. Conducted research and reviewed Attendance at Event forms, Outside Activity and Employment forms, and conflict of interest matters.

Partnered with Director to evaluate university’s compliance with state ethical guidelines.

Successfully developed, created, and maintained databases and data mining systems, data filtration process, application interface and transition, and electronic forms, filings, and processes; provided technical support.

** Prior experience as Billing Administrator with MetLife and Investigator BOA with Office of Boards & Commissions. **

Education & Credentials

MBA IN CORPORATE COMPLIANCE, Argosy University

MASTER OF JURISPRUDENCE IN HEALTH LAW & POLICY, Loyola University

BACHELOR OF BUSINESS ADMINISTRATION MANAGEMENT, Colorado Technical University

Professional Development: Human Resource Management; Organizational Systems Improvement; Global Business; Management Essentials; Project Planning; Sales & Marketing; Business Fundamentals; Accounting and Finance

Professional Affiliations: National Association of Black Compliance & Risk Management Professionals, Inc. (NABCRMP); Health Care Compliance Association (HCCA); Society of Corporate Compliance & Ethics (SCCE); AAPC; Practice Management Committee; Ethics & Compliance Committee

Technical Skills: Microsoft Office Suite, Modernizing Medicine EMA, Allscripts Practice Management System, SRS, Greenway, PaperPort, iPad Application & Form Building, iRound, Active Strategy, Active DC, DocStar & DocuWare, Troubleshooting, End-user Support, Data Mining, Data Control Operations, Network Support, Database Development



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