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Compliance & Risk Manager, University Health Service - Rochester, United States - GreaterROC
Description
OpeningFull Time
40 hours
Range URG 113
University Health Service
Schedule
8 AM-5 PM
Responsibilities
GENERAL PURPOSE:
With general oversight from the Director, the Compliance & Risk Manager is responsible for ensuring end to end regulatory compliance for the Student Health Insurance Plan as governed by NY state insurance law including but not limited to plan requirements, vendor selection, plan marketing, eligibility, and accounting practices.
of Financial Services, both of which will be led by the Compliance & Risk Manager to ensure all requirements are met.
In addition, they will play a critical role in developing and implementing programs, policies, and practices to ensure that University Health Service programs remain in compliance with organizational, accreditation, and governmental standards.
Acts as the UHS Privacy Officer.RESPONSIBILITIES:
Student Health Insurance Plan (SHIP) Compliance & Risk Management
As the subject matter expert on federal and New York State insurance law, leads compliance and risk management efforts for the SHIP.
Supports strategy development for student benefit design by ensuring that a high quality, affordable health insurance plan is available for UR students by reviewing information from DFS, Aetna, our actuary, our accountant and our auditor and make recommendations on how to best respond to and adjust the plan.
Manages, maintains, and monitors all documents, processes and strategies associated with adherence to insurance laws.Assists the Director in developing vendor standards and practices, procurement processes, and contract standards and then monitors those standards.
Ensures regulatory compliance in vendor selection, plan marketing, student/dependent eligibility and accounting practices.
Manages and leads compliance efforts for 23NYCRR500 (cyber security)
Monitors risk assessment data, identifies key risks, and leads the development of mitigation action plans.
SHIP Filing, Audit, & Examination Management
Leads the required annual form filing and periodic audits and examinations to ensure satisfactory results.
Prepares NYS DFS required reports, query responses, document submission and audits.
Maintains process and procedures relating to request from DFS
Responsible for monitoring recommendations and tracking improvements.
UHS Clinical Program Compliance & Risk Management
Leads compliance and risk management efforts for UHS clinical programs of primary care, counseling, and occupational health.
Manages, maintains, and monitors all documents, processes and strategies associated with adherence to applicable federal and state laws, and medical billing rules.
Ensures compliance with coding and billing for services provided, including educating providers and staff.Acts as Privacy Officer for UHS - Responsible for the privacy of protected health information through ongoing activities consisting of development, implementation, maintenance of and adherence to University of Rochester policies and procedures in compliance with federal and state laws
Accreditation
Leads efforts to ensure continuous compliance with accreditation standards of the Accreditation Association for Ambulatory Health Care (AAAMC).
Acts as project lead for accreditation renewals.
Special Projects and Assignments
Leads/participates in other projects and assignments in support of maintaining compliance and risk mitigation for UHS and SHIP.
QUALIFICATIONS:
Bachelor's degree required
or equivalent combination of education and experience preferred
Master's degree preferred
8 years of relevant experience required
or equivalent combination of education and experience required
Knowledge of information security risk management frameworks and compliance practices required
Strong interpersonal communication skills, presentation skills, including written communication required
Exceptional oral and written communication skills to be used with all levels of management, across multiple departments, and both internally and externally, with an ability to express information security concepts in simplified terms required
Operate with a high degree of independence with regard to project management activities, including development of project plans, customer meetings and audit sessions required
The University of Rochester is committed to fostering, cultivating, and preserving a culture of equity, diversity, and inclusion to advance the University's mission to Learn, Discover, Heal, Create – and Make the World Ever Better.
In support of our values and those of our society, the University is committed to not discriminating on the basis of age, color, disability, ethnicity, gender identity or expression, genetic information, marital status, military/veteran status, national origin, race, religion/creed, sex, sexual orientation, citizenship status, or any other status protected by law.
This commitment extends to the administration of our policies, admissions, employment, access, and recruitment of candidates from underrepresented populations, veterans, and persons with disabilities consistent with these values and government contractor Affirmative Action obligations.
How To ApplyAll applicants must apply online.
EOE Minorities/Females/Protected Veterans/Disabled
Pay Range
Pay Range:
$75,650 - $113,464 Annually
The referenced pay range represents the minimum and maximum compensation for this job.
Individual annual salaries/hourly rates will be set within the job's compensation range, and will be determined by considering factors including, but not limited to, market data, education, experience, qualifications, expertise of the individual, and internal equity considerations.
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