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Exemption Status

Exempt

Schedule Details

Monday through Friday

Scheduled Hours

8 AM - 5 PM

Shift

1 - Day Shift, 8 Hours (United States of America)

Hours

Cost Center

99940 - 5692 Corporate Compliance

This position may have a signing bonus available a member of the Recruitment Team will confirm eligibility during the interview process.

Everyone Is a Caregiver

At UMass Memorial Health, everyone is a caregiver – regardless of their title or responsibilities. Exceptional patient care, academic excellence and leading-edge research make UMass Memorial the premier health system of Central Massachusetts, and a place where we can help you build the career you deserve. We are more than 16,000 employees, working together as one health system in a relentless pursuit of healing for our patients, community and each other. And everyone, in their own unique way, plays an important part, every day.

I. Major Responsibilities

Develops positive relationships with senior leadership, management and caregivers, and encourages these internal clients to contact the ACO for proactive guidance to assure compliance with applicable regulations and UMass Memorial policies and procedures. Researches solutions and provides timely guidance to internal clients.
Conducts investigations as required, with the involvement Compliance senior leadership, the Office of the General Counsel, the Privacy Office and Human Resources as appropriate.
Processes cases received through the UMass Memorial Confidential Reporting System.
Documents cases, regardless of method reported, in the Compliance incident management system. Tracks cases to assure timely follow up.
Develops and tracks corrective action plans for audits and investigations.
Provides operational support for the Management Compliance Committee, as assigned. Plans agenda, develops applicable deliverables, ensures required work is clearly communicated to Committee personnel with deliverable dates. Ensures timely follow up on deliverables.
Collaborates with the Office of the General Counsel, Risk Management, Quality and Regulatory Affairs and the Compliance, Privacy and Information Security Offices in managing applicable compliance program(s).
Conducts reviews of entity and UMass Memorial corporate contracts as a compliance subject matter expert.
Assists in the development, management and maintenance of Compliance policies and procedures, the Code of Ethics and Business Conduct, and related documentation.
Assists in the development and delivery of compliance training.
Helps to oversee exclusion checking, and provides guidance to resolve potential matches.
As assigned, assists in the development of entity annual Compliance Work Plans and the UMMH annual Compliance Work Plan.
May assist in the implementation and/or maintenance of the conflict of interest program(s).
Prepares periodic dashboards and reports for various senior leadership audiences, and identifies trends and opportunities for improvement.
Researches and remains current on key regulatory compliance risks.
Researches topics, assimilates information, and communicates effectively in person and in writing.
Directs and supervises personnel if/as assigned including performance evaluations, scheduling, orientation, and training. Makes recommendations on employee hires, transfers, promotions, salary changes, discipline, terminations, and similar actions. Resolves grievances and other personnel problems within position responsibilities.

Standard Staffing Level Responsibilities

Complies with established departmental policies, procedures and objectives.
Attends variety of meetings, conferences, seminars as required or directed.
Demonstrates use of Quality Improvement in daily operations.
Complies with all health and safety regulations and requirements.
Respects diverse views and approaches, demonstrates Standards of Respect, and contributes to creating and maintaining an environment of professionalism, tolerance, civility and acceptance toward all employees, patients and visitors.
Maintains, regular, reliable, and predictable attendance.
Performs other similar and related duties as required or directed.

II. Position Qualifications

All responsibilities are essential job functions.

License/Certification/Education

Required:

Bachelor’s degree
Certification in Healthcare Compliance (CHC). If not already obtained, CHC certification will be required within twelve months of employment as a condition of employment.

Preferred

Master’s or similar advanced degree in related field (law, healthcare administration, nursing, business administration or accounting/finance)
Certified in Healthcare Privacy Compliance (CHPC)

Experience/Skill

Required:

Minimum five (5) years of healthcare compliance experience.
Knowledge of key healthcare fraud and abuse and privacy laws and regulations.
Knowledge of various payment methods for inpatient and outpatient services.
Strong interpersonal skills and leadership ability.
Strong analytical, written and oral communication skills.
Experience in public speaking and business presentations.
Strong PC literacy (Microsoft Word, Excel, SharePoint, PowerPoint).

Unless certification, licensure or registration is required, an equivalent combination of education and experience which provides proficiency in the areas of responsibility listed in this description may be substituted for the above requirements.

Department-specific competencies and their measurements will be developed and maintained in the individual departments. The competencies will be maintained and attached to the departmental job description. Responsible managers will review competencies with position incumbents.

III. Physical Demands And Environmental Conditions

Work is considered sedentary. Position requires work indoors in a normal office environment.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.

We’re striving to make respect a part of everything we do at UMass Memorial Health – for our patients, our community and each other. Our six Standards of Respect are: Acknowledge, Listen, Communicate, Be Responsive, Be a Team Player and Be Kind. If you share these Standards of Respect, we hope you will join our team and help us make respect our standard for everyone, every day.

As an equal opportunity and affirmative action employer, UMass Memorial Health recognizes the power of a diverse community and encourages applications from individuals with varied experiences, perspectives and backgrounds. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, gender identity and expression, protected veteran status or other status protected by law.

If you are unable to submit an application because of incompatible assistive technology or a disability, please contact us at talentacquisition@umassmemorial.org. We will make every effort to respond to your request for disability assistance as soon as possible.

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