Compliance Specialist at Beth Israel Deaconess Medical Center in Boston, Massachusetts

Job Description:

DEPARTMENT DESCRIPTION: This role is supporting the Beth Israel Lahey Health Compliance department and our physician practices.

JOB LOCATION: Boston, MA

REQ ID: 36487BR

JOB SUMMARY: The Physician Practice Compliance specialist is responsible for supporting the day-to-day operations of the Beth Israel Lahey Health (BILH) Primary and Specialty Care Services Compliance program and provides expertise, consultation and guidance for privacy and compliance activities. On a regular basis, the Compliance Specialist shall also report on the operation of the Primary and Specialty Care Compliance Program to the Director of Primary and Specialty Care Compliance. The Compliance Specialist will serve as a role model for ethical and moral principles that are consistent with the mission, vision, and values of BILH, the BILH Code of Conduct, and with the applicable principles required by federal and state law.

ESSENTIAL RESPONSIBILITIES:

* Functions as a team member responsible for day-to-day oversight and administration of the BILH Primary and Specialty Care Compliance Program, and ensures that the program operates in a manner consistent with the Office of Inspector General's recommendations for physician practices.

* Provides and guides partners at each of the Primary and Specialty care practice sites, on the seven elements of an effective compliance program, and provides support and oversight to key compliance initiatives across the Physician practice group sites.

* Regularly reports to the Director of Primary and Specialty Care Compliance on the status of the Primary and Specialty Care Compliance program, and assists him/her in establishing methods to reduce the vulnerability to fraud, abuse, and waste.

* Periodically reviews the compliance program in light of changes to the organization's needs, laws, and policies and procedures of government and private payer health plans to propose modifications, if necessary.

* Collaborates with other departments within BILH Primary Care and the BILH system (e.g., Office of Compliance and Business Conduct, Risk Management, Human Resources, Internal Audit and the Office of General Counsel) as needed to resolve compliance and legal issues.

* Monitors the development, coordination, and participation in a multifaceted educational and training program that focuses on the elements of the Primary and Specialty Care Compliance Program, and ensures that all employees, Physicians and management are knowledgeable of, and comply with, pertinent federal and state standards.

* Independently investigates and acts on matters related to compliance, including the flexibility to design and coordinate internal investigations (e.g., responding to reports of problems, 'hot-line' calls, or suspected violations) and any resulting corrective actions with all departments, providers and sub-providers, agents and, if appropriate, independent contractors.

* Collaborates with the Director of Primary and Specialty Care to contact legal department as needed to resolve compliance and legal issues, including matters related to contracts and agreements.

* May also investigate and direct the investigation of alleged violations of the Primary and Specialty Care Compliance Program with assistance of legal counsel, including working with appropriate parties to handle violations promptly, properly and consistently.

* Recognize, create and implement plans to promote diversity with the department and organization.

REQUIRED QUALIFICATIONS:

* Bachelor's degree required. Master's degree preferred.

* 3-5 years related work experience required in Professional experience in healthcare compliance..

* General knowledge of the seven elements of an effective Compliance Program. Report writing and data analysis skills.

* Advanced skills with Microsoft applications which may include Outlook, Word, Excel, PowerPoint or Access and other web-based applications. May produce complex documents, perform analysis and maintain databases.

COMPETENCIES:

* Decision Making: Ability to make decisions that are guided by general instructions and practices requiring some interpretation. May make recommendations for solving problems of moderate complexity and importance.

* Problem Solving: Ability to address problems that are varied, requiring analysis or interpretation of the situation using direct observation, knowledge and skills based on general precedents.

* Independence of Action: Ability to follow precedents and procedures. May set priorities and organize work within general guidelines. Seeks assistance when confronted with difficult and/or unpredictable situations. Work progress is monitored by supervisor/manager.

* WRITTEN COMMUNICATIONS: Ability to communicate clearly and effectively in written English with internal and external customers.

* ORAL COMMUNICATIONS: Ability to comprehend and converse in English to communicate effectively with medical center staff, patients, families and external customers.

* KNOWLEDGE: Ability to demonstrate full working knowledge of standard concepts, practices, procedures and policies with the ability to use them in varied situations.

* TEAM WORK: Ability to interact respectfully with other employees, professional staff and/or external contacts to offer ideas, identify issues, obtain information or deliver services.

* CUSTOMER SERVICE: Ability to provide a high level of customer service to patients, visitors, staff and external customers in a professional, service-oriented, respectful manner using skills in active listening and problem solving. Ability to remain calm in stressful situations.

PHYSICAL NATURE OF THE JOB:
Sedentary work: Exerting up to 10 pounds of force occasionally in carrying, lifting, pushing, pulling objects. Sitting most of the time, with walking and standing required only occasionally

Equal Opportunity Employer
Beth Israel Deaconess Medical Center is an Equal Opportunity Employer. We comply with the laws and regulations set forth by the U.S. Department of Labor.

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