This position oversees compliance as it relates to the $1.3B in revenue and 120,000 covered lives associated with SFHCP’s integrated payer contracting. Where applicable, this position is responsible for ensuring that the more than 1,300 providers of Saint Francis Healthcare Partners and their staff meet their compliance obligations. Under the direction of the Chief Compliance Officer, the Manager of Compliance, is responsible for the day-to day operations of the Saint Francis Healthcare Partners compliance program including partnering with leadership to provide education, performance of risk assessment, coordination monitoring activities, conducting compliance investigations and maintaining policies and procedures relating to compliance activities. This position is also responsible for the overall development and establishment of SFHCP policies & procedures and maintenance, monitoring and updating of the SFHCP/SFHCP ACO Compliance Plans, and ensuring that these programs meet standards set by state and federal laws and regulations. With the regionalization of Saint Francis Healthcare Partners, this position will be responsible for scaling the compliance programs to ensure compliance at each local clinically integrated network (CIN).
Education: Bachelor’s Degree required; Juris Doctorate, Certified Public Accountant or Masters in Healthcare preferred
Experience: Two-four years of experience in health care compliance, regulatory or legal, auditing, or other relevant experience. Combination of experience and/or education can be taken into consideration.
Certification: Certification in Healthcare Compliance required, HCCA-CHA or CHC.
Skills: Knowledge of Federal healthcare program requirements and federal and state healthcare laws and regulations. Effective oral and written communication skills; strong analytical, interpersonal and project management skills; good computer skills including proficiency in Microsoft Office products including word and excel. Knowledge of business operations related to accountable care organizations, clinically integrated networks, HIPAA business associates and managed care compliance obligations preferred.