Compliance Analyst / UMMS

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Job ID: 52249
Area of Interest: Professionals
Location: Baltimore, MD US
Hours of Work: M-F, 8a-5p
Job Facility: University of Maryland Medical System
Employment Type: Full Time
Shift: DAY
What You Will Do:

The University of Maryland Medical System is a 12-hospital system with academic, community and specialty medical services reaching every part of Maryland and beyond. UMMS is a national and regional referral center for trauma, cancer care, Neurocare, cardiac care, women's and children's health and physical rehabilitation. UMMS is the fourth largest private employer in the Baltimore metropolitan area and one of the top 20 employers in the state of Maryland. No organization will give you the clinical variety, the support, or the opportunities for professional growth that you’ll enjoy as a member of our team. UMMS is currently seeking a Compliance Analyst for our Corporate location.

*** Bachelor’s degree in business administration, healthcare, or a relevant field and 2 years work experience in a business, professional or health care environment, including 1 year experience in a Compliance, Internal Audit, Billing, Coding, Education and Training, Case Investigations, Research or equivalent related fields is REQUIRED***

Under the supervision of the Director of Compliance, the analyst will manage, develop, implement and monitor policies, procedures, processes, training, corrective action plans and overall operations to ensure compliance with federal and state laws and regulations affecting the Medical System and its Affiliates. Additionally, the Analyst will work collectively with Affiliate management and other personnel to ensure that compliance initiatives are implemented at all UMMS affiliates. For assigned components, individuals will be responsible for leading efforts implementing, monitoring and tracking Compliance Program elements and providing direction and guidance to affiliate personnel for adherence to industry regulations, system policies, Federal Sentencing Guidelines, CMS Conditions of Participation, Conditions of Payment and State specific requirements.

The following statements are intended to describe the general nature and level of work being performed by the individuals assigned to this classification. These are not to be construed as an exhaustive list of all job duties performed by personnel.

Principal responsibilities of a Corporate Compliance Analyst include:

1. Serves as case investigator and performs follow-up with affiliate personnel on complaints and inquiries received through the Compliance Hotline, internal reporting, or other reporting and monitoring mechanisms.

2. Develops closing summary reports for case investigations and performs follow through to determine implementation of corrective action plans.

3. Serves as a consultant to UMMS operations personnel including Affiliate Compliance Officers for compliance questions and collaborate with affiliate management personnel in the development of corrective action plans.

4. Prepares reports to meet the needs of the Chief Compliance Officer, Director of Compliance, and UMMS executive management and the Audit and Compliance Committee of the Board of Directors.

5. Conducts audits/reviews and performs analysis to determine compliance with applicable federal and state laws, and policies and procedures.

6. Monitors data and trends to determine deficiencies and/or areas for further investigation and provides recommendations.

7. Develops and implements compliance policies as requested by the Compliance Director.

8. Carries out compliance research on specific topics such as Privacy regulations, Conflict of Interest Standards, Billing & Coding, policy development and healthcare regulations.

COMPLIANCE SUBJECT-MATTER AREAS

Manages all aspects in one or more subject-matter areas of Compliance operations and works directly with Corporate Compliance Directors to implement specific components of the annual Compliance Plan. Specific Compliance subject matter areas include:

Compliance Administration

1.  Education, both general and supplemental, development, distribution and presentation. Healthcare compliance and regulatory research.

a) Analyzes, prioritizes and provides supporting research theory on researched data and summarizes in a presentable format for discussion with management.

b) Prepares departmental research reports inclusive of supporting documentation and executive summaries as applicable.

c) Identifies education and training needs across organization’s shared services and affiliates. 

d) Carries out compliance special projects such as compliance internal education and training requirements, development and of training modules and loading into learning management system and annual review and revision of organizations learning portal library.

2.  HIPAA Privacy and Security

a) HIPAA Privacy and Security and serves as Liaison to Hospital Privacy Officers

b) Prepares required HIPAA breach reporting for reporting submission and enters into current government reporting system as required after review by Compliance Director.

c) Develops related HIPAA Privacy, IT and Security policies and collaborates with IS&T with implementation across the System.

d) Leads Corporate Compliance and Hospital Privacy Officer Committee Roundtable meetings

e) Identifies and provides related HIPAA Privacy and Security education and training opportunities.

f) Collaborates with Hospital Privacy Officers and HIM staff to investigate, mitigate and resolve HIPAA Privacy related incidents.

3.  Compliance Program Metrics

1. Manages validation of Compliance Program Metrics, identifies gaps and develops and reports aggregated data by Affiliate. Develops management and committee reports based on aggregated System data.

a) Collects documentation from Hospital Compliance Officers quarterly and annually regarding their Compliance Program Metrics and assists in determining documentation is appropriate, reviews for statistical accuracy, meets standards, requests more information if required, and ensures it is complete.

b) Works collaboratively with Hospital Compliance Officers in understanding and continually monitoring the metrics, identifying educational gaps and develops process and training tools to close those gaps.

c) Completes required metrics summary chart and highlights overview for management presentation

d) Prepares corporate compliance summaries of project research into electronic formats for meetings and presentations

e) Validates data as requested and makes recommendations to improve the accuracy of the data. Presents ideas for modifications and additions to the metrics to make the Compliance Program more robust or measure compliance outcomes.

Employee Benefits

As a University of Maryland Medical System (UMMS) employee, you will enjoy a comprehensive benefits program designed with you and your dependents in mind. Subject to any eligibility waiting period, all of the benefits are available to regular full-time employees and most benefits are available to regular part-time employees who are regularly scheduled to work twenty (20) or more hours per week. Many benefits are provided at no cost to employees. For others, the cost is shared between UMMS and employees.



What You Need to Be Successful:

Bachelor’s degree in business administration or healthcare or a relevant field would be required. 

2 or more years of experience in a business, professional or health care environment, including one year experience in a Compliance, Internal Audit, Billing, Coding, Education and Training, Case Investigations, Research or equivalent related fields is required.

Experience with data analysis tools and techniques are preferred.

Knowledge, Skills and Abilities

1. Must be able to maintain confidentiality of all compliance related or other reported issues.

2. PC literate with intermediate proficiency in Microsoft Office Suite, Visio, Internet and data analysis tools and techniques. 

3. Effective verbal, written and interpersonal skills to communicate with colleagues, patients and/or visitors to establish strong working relationships. 

4. Strong problem solving and decision-making skills.

5. Knowledge of Medicare Reimbursement System and/ or billing and coding rules.

6. Knowledge of Learning Management Systems (LMS)

7. Knowledge of risk assessments and monitoring activities related to compliance risks.

8. Knowledge to effectively communicate with health care providers at all levels.

9. Strong analytical skills.

10. Ability to work in a self-directed team by taking and giving direction and sharing in the responsibility of the team. 

11. Self-motivated. Able to evaluate the scope of each day’s work and use time management and organizational skills to accomplish assignments.

 


We are an Equal Opportunity/Affirmative Action employer.  All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected veteran status, age, or any other characteristic protected by law. 
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