Healthcare Compliance Manager

The Healthcare Compliance Manager is responsible for ensuring that Lone Star Family Health Center is conducting business in full compliance with all applicable regulations, professional standards, and internal policies.

Essential job functions

• Develops and updates the organization’s risk management program with coordination from various other operating departments (nursing, facilities, human resources, finance, etc.)
• Manages liability, property and specialty insurance portfolio (coverage outside of health insurance and worker’s compensation)
• Promotes compliance with all applicable regulations, including but not limited to HIPAA
• Performs periodic internal reviews or audits to ensure that compliance procedures are followed
• Identifies compliance issues that require follow-up or investigation
• Conducts or assists with the internal investigation of compliance issues
• Maintains documentation of compliance activities, such as complaints or investigation outcomes
• Files appropriate compliance reports with regulatory agencies
• Reports violations of compliance or regulatory standards to authorized enforcement agencies as required
• Serves as a confidential point of contact for employees to communicate with management, seek clarification on issues or dilemmas, or report irregularities
• Maintains a confidential compliance hotline
• Ensures employee training on compliance related topics
• Consults with corporate attorneys as necessary to address difficult legal compliance issues
• Provides assistance to internal or external auditors in compliance reviews
• Collaborates with other departments on complaints, incident reports, grievances and medical malpractice concerns
• Facilitates the maintenance, periodic review/approval, and distribution/communication of all internal policies and procedures
• Periodically reports to the Compliance/Performance Improvement committee, CEO and Board of Directors on compliance activities
• Stays informed on industry changes, trends and best practices and assesses the potential impact of these changes on the organization
• Prepares the annual Federal Tort Claims Act (FTCA) application renewal
• Receives all legal notifications and processes them according to LSFHC’s claims management policy
• Acts as the primary spokesperson for the facility to persons who have a complaint that may be considered a potentially compensable claim
• Serves as the organization’s Privacy and Compliance Officer

Education/Experience

Bachelor’s Degree required; Master’s preferred.

Minimum of five to seven (5 – 7) years’ experience in the healthcare industry with compliance responsibilities

Licenses and Certifications

Certificate in Healthcare Compliance (CHC), Healthcare Privacy Compliance (CHPC) and/or Compliance and Ethics Professional (CCEP) preferred