Value Based Care Compliance Manager - Dallas, United States - Conifer Revenue Cycle Solutions

Conifer Revenue Cycle Solutions
Conifer Revenue Cycle Solutions
Verified Company
Dallas, United States

1 week ago

Mark Lane

Posted by:

Mark Lane

beBee recruiter
Description

JOB SUMMARY


The Compliance Manager contributes to Conifer Health's (Conifer) purpose by providing both strategic and day-to-day leadership to the compliance program designed to ensure Conifer fully complies with its Standards of Conduct and all applicable laws and regulations as it relates to value-based care.

The Compliance Manager will lead and support compliance program initiatives and provide leadership for a variety of projects as it relates to the value based care programs.


Develops, implements, and oversees the compliance program; including (1) maintaining and expanding visibility of the compliance program at all levels within the organization (2) ensuring there is an effective compliance program and oversight in place to remain compliant with all local, state, and federal healthcare rules, regulations and adimistrative requirements and (3) collaborating with team members to support programmatic efforts.


ESSENTIAL DUTIES AND RESPONSIBILITIES

  • Include the following. Others may be assigned._

Conifer Value Based Care Compliance Program Operations
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Coordinates audit responses and corrective actions as it relates to the Compliance Program.
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In conjunction with Chief Compliance Officer, coordinates attestation related to Conifer Value-Based Care Compliance Program oversight of vendors as it relates to CMS compliance program requirements.
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Supports Compliance Investigations Officers as Subject Matter Expert in the process for investigating and addressing internal/external complaints regarding regulatory requirements, including validation of remedial activities, as applicable.
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Oversees the development and implementation of compliance policies and procedures related to Conifer Value-Based Care.
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Assists in monitoring and interpreting regulatory changes related to Conifer Value-Based Care. Supports efforts to respond to new or changing regulations, including but not limited to assessing impact of regulations from a compliance program perspective in conjunction with leadership and affected departments.
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Reporting of incidents as required by Client Plan contracts, including concerns related Fraud, Waste and Abuse, and Privacy Breaches, in coordination with Leadership
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Reduces organization risk by identifying risks related to Conifer Value-Based Care and manages annual work plan items to address identified risks.
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Contributes to the annual compliance monitoring plan and the components related to Conifer Value-Based Care activities, as needed.
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Develops and implements key compliance monitoring activities related to third-party oversight, as required by CMS.
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Attend key operational meetings to provide compliance guidance, matter trending and assess opportunities for proactive risk management
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Leads and/or participates in organizational projects related to the design, implementation, revision or maintenance of process and systems that promote compliance.
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Serves as a business partner, internal expert and advisor in compliance matters
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Collaborates with key leadership, team members, contractors and other stakeholders throughout Conifer to promote a culture of compliance.
KNOWLEDGE, SKILLS, ABILITIES

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

  • Ability to work independently with little supervision and seek guidance as needed to clarify assignments or request for information.
  • Excellent communication, customer service and timemanagement skills
  • Strong teambuilding and development skills
  • Possess basic business skills, an understanding of general compliance operations and department goals in the healthcare environment.
  • Intermediate knowledge of relational database management systems
  • Must be a team player
  • Always willing to help in whatever way possible and go the extra mile to get the job done.
  • Intuitive and skilled at problem solving in anticipation of team member and client request
  • Have the ability to make logical correlations between data points to determine if analysis is accurate
  • Detail oriented, meticulous and accurate in completing tasks on time.
EDUCATION / EXPERIENCE

  • Include minimum education, technical training, and/or experience preferred to perform the job._
  • Bachelor degree in Business, Health Care Administration; Juris Doctorate or related field or equivalent years of related Manager experience required.

REQUIRED CERTIFICATIONS/LICENSURE

  • Include minimum certification required to perform the job._
  • Certified Healthcare Compliance (CHC) is preferred
  • Managed Care experience preferred

PHYSICAL DEMANDS
The physical demands described here are representative of those that must be met by an employee to successfully perform th
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