- Coordinating as appropriate with outside legal counsel, conducting or authorizing, and overseeing investigations of matters that merit investigation under the Compliance Program
- Support client legal escalation requests, research contract terms, and management of terminations
- Develop and coordinate appropriate compliance training and education programs for all employees. Ensure and understand the company's commitment to comply with all laws, regulations, company policies, and ethical requirements applicable to the conduct of business. Assess the need for additional training and education and develop appropriate Compliance Program
- Develop, coordinate, and/or oversee internal and external audit procedures for the purpose of monitoring and detecting any misconduct or noncompliance. If any misconduct or noncompliance is detected, recommend a solution, and follow up to ensure that the recommendations have been implemented
- Analyzes and interprets existing, new and proposed legislation for system-wide program impacts;
- Collaborate with cross-functional teams to coordinate compliance efforts and address compliance-related issues
- Conduct risk assessments and audits to identify compliance gaps and areas for improvement
- Develop, update, and maintain policies and procedures to ensure compliance with applicable laws and regulations
- Facilitate the intake and review of contract requests and serve as a point of contact for referral source contracting matters at assigned care site(s)/region(s)/system services business units
- Foster effective communication and relationships with all healthcare personnel to promote a culture of compliance
- Identifies areas of compliance vulnerability, determines appropriate action, makes recommendations for resolution, and assists in the implementation of program enhancements and improvements;
- Leads large, complex projects to achieve compliance objectives
- Manages compliance incidents management and related processes, including associated corrective action plans
- Participates in appropriate level of response, develops corrective action plans, and oversees compliance investigations while maintaining confidentiality of information reported, as appropriate;
- Participates in collaboration with cross-functional teams to achieve key job responsibilities
- Perform regulatory research and analysis on a variety of corporate, healthcare, related regulatory topics
- Bachelor's or equivalent experience
- Minimum of 3-5 years of experience in a healthcare compliance, regulatory and / or legal role.
- Strong understanding of healthcare regulations, laws, and standards
- Strong understanding of legal concepts related to service agreements
- Excellent communication, problem-solving, and critical thinking skills
- Demonstrated ability to develop and deliver effective policy and procedures
- Proficiency in data analysis techniques and technologies to support compliance monitoring
- Knowledge of quality improvement methodologies and approaches in healthcare
- Familiarity with risk management principles in the healthcare context
- Experience with applicable legal concepts related to a business process outsourcing firms
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Compliance Analyst - Chesterfield, United States - Nimble Solutions
Description
Why you'll want to work at nimbleThis is a great opportunity to join a well-established and market-leading brand serving a high growth end market while gaining valuable experience working closely with Executive leadership. As an organization, we are in high growth mode through acquisition with a laser focus on positive culture building
Who we are:
nimble solutions is a leading provider of revenue cycle management solutions for ambulatory surgery centers (ASCs), surgical clinics, surgical hospitals, and anesthesia groups. Our tech-enabled solutions allow surgical organizations to streamline their revenue cycle processes, reduce administrative burden, and improve financial outcomes. Join more than 1,100 surgical organizations who trust nimble solutions and its advisors to bring deep insights and actionable intelligence to maximize their revenue cycle.
The Compliance, Regulatory and Legal Program Manager provides subject matter expertise to the compliance program and operational stakeholders. This role is responsible for identifying and assessing areas of compliance and legal risk. The Compliance, Regulatory, and Legal Program Manager displays expertise in the principles and practices of compliance in the health care field, including relevant laws, regulations, policies and standards related to health care fraud, waste and abuse, billing and coding, clinical documentation, privacy and information security, research, and/or ethics.
On a typical day, here's what you'll be working on:
Who you are
