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Senior Compliance Consultant Union City, CA



Description

In adherence with the KP Compliance Framework, fosters comprehensive compliance management with assigned client organizations through a series of activities to comply with all applicable regulations and statutes. Develops solutions to a variety of compliance problems of significant scope and complexity.

Essential Functions:
- Project Planning: Identifies accountabilities for local /regional compliance program and consulting staff. Develops Compliance work and Audit plans.
- Collaborates in the development and completion of annual risk assessments.
- Takes complex ideas and input to develop/create project plans&strategies in support of established approach, goals,and time frames.
- Participates on and may establish compliance related committees/work groups to cultivate and reinforce appropriate group values, norms and behaviors.
- Leads compliance-related projects. Identifies&manages internal/external resources and agency relationships.
- Investigations: Performs routine and non-activities utilizing various compliance tools, databases and software applications.
- Performs complex analyses to identify potential compliance issues and areas of compliance requirements.
- Collaborates with other functional areas in investigating potential compliance issues.
- Develops investigation project plans. Independently or in collaboration, conducts fact finding interviews and summarizes investigational findings and recommendations.
- Collaborates with clients to determine simple corrective action plans appropriate to substantiated allegations and investigation findings.
- Validation: Participates and may lead in audits on scope of practice, licensing, site of service and other identified areas at risk for compliance violations.
- Consults in the development of Corrective Action Plans for identified compliance risk, monitors completion and periodically validates operational sustainability.
- Reviews compliance programs and content, including designing and conducting risk assessments and/or audits, and investigating instances of reported non-compliance.
- Assists with determining impacts of implementation of new regulations and statutes and required notifications, changes, and training.
- Communicates required changes, develops tools to assess risks, and leverages existing workgroups/etc. to facilitate required changes.
- Researches and stays abreast of regulations and statutes exhibiting extensive knowledge on a wide variety of clinical and non-clinical compliance issues.
- Implementation: Identifies and implements OIG compliance requirements; conducting related analyses.
- Assesses and synthesizes complex information to develop new solutions to existing alternatives.
- Creates, develops and revises basic and complex compliance standards, policies and procedures, including but not limited to privacy and security, fraud, waste and abuse, non-retaliation, disciplinary action, vendor relations etc.
- Monitors compliance adherence, reporting results to all levels of the organization.
- Influences management and staff to ensure compliance and reporting on compliance efforts and programs.
- Develops and/or conducts compliance and ethics training.


Qualifications:

Basic Qualifications:
Experience
- Minimum five (5) years of heath care compliance, health care operations (quality, risk, etc.), audit, finance, project management, regulatory or public policy development, investigations, information security, or insurance/health plan governance experience.
Education
- Bachelor's degree required, OR four (4) years of experience in a directly related field.
- High School Diploma or General Education Development (GED) required.
License, Certification, Registration
- N/A

Additional Requirements:
- Thorough knowledge of compliance principles, theories, and concepts.
- Thorough knowledge of health care compliance policies, programs, practices, systems, related compliance issues.
- Thorough knowledge of the elements of an effective Ethics and Compliance program and broad knowledge of health care industry practices and standards including both federal, state regulations and accreditation standards.
- Excellent skills in written and verbal communication, meeting facilitation, presentations, analysis, collaboration, project management, decision making and stewardship.
- Must be able to work in a Labor/Management Partnership environment.

Preferred Qualifications:
- Master's degree in health care administration, business administration, finance, economics, operations research, public health or other health care related field preferred.
- Healthcare experience preferred.
- Certified in Healthcare Compliance(CHC) preferred.
- Strong skills required in critical thinking, analysis, meeting facilitation, verbal and written communication, and interpersonalinteractions (e.g., partnering, conflict management, consulting, etc.)


Primary Location: California,Union City,Union City Landing Administration 30116 Eigenbrodt

Scheduled Hours (1-40): 40

Shift: Day

Working Days: Mon - Fri

Schedule: Full-time

Job Type: Standard

Employee Status: Regular

Employee Group: Salaried, Non-Union, Exempt

Job Level: Individual Contributor

Job: Compliance / Privacy / Regulatory

Public Department Name: GSAA Compliance and Privacy


External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with Federal, state and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran, or disability status.

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