Corp Regulatory Consultant - Compliance Department - INTEGRIS
Job Code: 2528
Responsible for the development and periodic review of regulatory oversight functions within the compliance program; the development of regulatory aspects of compliance training and education programs, will communicate regulatory problems to corporate compliance officer, compliance director and other appropriate responsible parties, including executive leadership in one-on-one or group meetings and presentations. Will advise and verify when regulatory changes are made and ensure that proper changes are implemented. Will be the authority to answer and address questions from regarding federal and state regulations. Will utilize critical thinking skills as a self-starter, problem resolution, analysis, and negotiation.
INTEGRIS Health is an Equal Opportunity/Affirmative Action Employer. All applicants will receive consideration regardless of membership in any protected status as defined by applicable state or federal law, including protected veteran or disability status.
The Regulatory Compliance Consultant responsibilities include, but are not limited to, the following:
* Establish process for regulatory oversight, monitoring and reporting regarding proposed regulatory rules and regulatory changes and updates
* Assists with the development of policies and procedures as it relates to regulatory compliance requirements, Federal Programs and compliance risks areas such as, Medicare, Medicaid and other Federal or State regulatory billing compliance, Stark, Anti-Kickback and fraud, waste and abuse and participates in the development of an educational and training programs that focuses on the regulatory elements of the compliance program.
* Provides regulatory expertise in developing the compliance program work plan, annual auditing and monitoring plan.
* Builds, develops and maintains operations to support strategic direction for areas of responsibility.
* Maintains a current working knowledge of Federal and State regulations and policies as they affect through routine review of various coverage and payor manuals, Federal Register and states laws, rules and regulations; multiple stated Medicaid manuals, and multiple State Board of Pharmacy regulations;
* Monitors notices, applicable government and/or industry related internet information sites,
* Provides education and training about actual, proposed, or pending legislation and regulations that affect operations and identifying operational obstacles to compliance, and working with other employees to identify and implement solutions
Reports to Vice President.
Required Physical Demands (Subject to Reasonable Accommodation):Keyboarding/Dexterity: Frequently; activity exists from 1/3 to 2/3 of the time
Standing/Walking: Occasionally; activity exists up to 1/3 of the time
Strength (Lift/Carry/Push/Pull): Sedentary (exerting up to 10 pounds of force occasionally)
Talking (Must be able to effectively communicate verbally): Yes
Color Acuity (Must be able to distinguish and identify colors): No
This position may have additional or varied physical demand and/or respiratory fit test requirements. Please consult the Physical Demands Project SharePoint site or contact Risk Management/Employee Health for additional information.
Normal office environment.
* Bachelor degree in business, health-care administration, area of clinical expertise, or other related field
* JD degree preferred
* 7 years of work experience in the field
* Knowledge of leadership, management, and quality improvement concepts
* Skilled in Regulatory review response and planning
* Knowledgeable of healthcare compliance laws and regulations; Federal and State legislation interpretation
* Knowledge and expertise in Stark law, Anti-kickback statute, False Claims Act, EMTALA, Physician compensation, Medicare, Medicaid, Payors
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