Position Summary

The Millennium Physician Group Compliance, Ethics & Risk Privacy Specialist assists the Millennium Physician Group Chief Compliance, Ethics & Risk Officer with the daily application of the Millennium Physician Group Compliance Plan. This position involves assisting the Chief Compliance, Ethics & Risk Officer with investigating and monitoring compliance and privacy issues that arise out of the Millennium Physician Group offices and operations. The Compliance, Ethics & Risk Privacy Specialist will assist with identifying, resolving, training, and monitoring issues in the areas of improper conduct, fraud, waste and abuse, and other remediation necessary for coding, billing, documentation, and reimbursement compliance matters. This position reports to the Chief Compliance, Ethics & Risk Officer & Privacy Officer.

Essential Job Functions

• Supports the development and maintenance of all 7 elements of a Compliance Program; and assists with the promotion of a compliance culture for the organization.
• Strong written and verbal communication skills.
• Responds to reported concerns and incidents in a timely manner and in collaboration with the Chief Compliance, Ethics, & Risk Officer.
• Assists with developing and providing training to staff and management in collaboration with Chief Compliance, Ethics & Risk Officer.
• Remains abreast of relevant regulatory publications and settlements.
• Researches pertinent state and federal regulations.
• Assists with the planning and execution of risk assessments.
• Supports the planning and design of audits. (Compliance 360)
• Supports the Compliance, Ethics & Risk Department with generating reports used to track and trend activities related to compliance. (Compliance 360)
• Maintains library of training resources via electronic methods and/or hard copy
• Writes or researches initial draft materials for new training programs; reviews, evaluates and modifies existing and proposed programs; recommends appropriate changes.
• Gathers, collects, and tracks data using the C360 modules. Generates electronic and hard copy reports/metrics.
• Other duties as assigned.

Duties and Responsibilities

• Supports the day-to-day operations of the Compliance Plan as directed by the Millennium Physician Group Chief Compliance, Ethics & Risk Officer.
• Participates in the development and execution of audits that correlate with the Millennium Physician Group Audit Plan and OIG Guidance for Physician Practices and related ancillary services pertaining to coding, billing, documentation, and reimbursement and privacy activities. (Compliance 360)
• Periodically reviews and recommends updates to compliance policies, procedures and Compliance Plan to ensure relevance in providing guidance to management and employees. (Compliance 360)
• Assists with responses to alleged violations of rules, regulations, policies, procedures, client contractual requirements by evaluating and/or initiating an investigation as appropriate. (Compliance 360)
• Reports and escalates identified high-risk issues immediately to the Chief Compliance, Ethics, & Risk Officer.
• Identifies potential areas of compliance vulnerability and risk, facilitating corrective action plans for resolution.
• Collaborates with Millennium Physician Group Chief Compliance, Ethics & Risk Officer to develop effective compliance training programs to include new employee orientation, targeted education and ongoing education for management and employees.
• Provides reports as directed and/or requested to the Millennium Physician Group Chief Compliance, Ethics & Risk Officer on issues and concerns as listed above.
• Other projects as assigned.

Education /Experience / Requirements/ Qualifications

• Bachelor's degree required.
• CHC (Certified in Healthcare Compliance) required.
• 3-5 years minimum of industry related experience in healthcare compliance, operations, privacy, quality, and training.
• Familiarity with some of the various regulations including but not limited to:

• • Stark, Anti-Kickback
  • HIPAA,
  • HITECH
  • Florida State privacy laws.

• Review and interpret healthcare compliance regulations including HIPAA Privacy, Coding, Billing, Exclusions, Investigations and Corrective Action Plans.
• Ability to identify, analyze and investigate potential privacy incidents involving PHI.
• Ability to work with and maintain confidentiality of physician, patient, patient account and personnel data.
• Ability to work effectively within a team environment.
• Clear, concise and persuasive writing and presentation skills.
• Decisive and capable of exercising good judgment under pressure.
• Ability to be flexible, manage a diverse and demanding workload with minimal supervision.
• Competencies related to MS Office Suite including Word, Excel and PowerPoint.
• Outstanding organizational skills with demonstration of exceptional planning and coordination
• Demonstrated ability to problem solve and manage unforeseen changes to plans
• Excellent multitasking ability
• Outstanding communication skills
• Strong attention to detail
• Experience and skill with providing excellent customer service and maintaining cooperative working relationships in and outside the department.
• Experience with Microsoft Office tools (Word, PowerPoint, Excel).
• Preferred: Data analysis, evaluation and reporting skills, especially utilizing Excel and survey tools, Universal Assessments (SAI Global module)

Qualifications:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Language Skills

Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively before groups of customers or employees of organization.

Mathematical Skills

Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, percentages, area, circumference, and volume. Ability to apply concepts of basic algebra and geometry.

Reasoning Ability

Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.

Physical Demands The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Physical and Mental requirements:

• Constantly operates a computer and other office equipment to coordinate work.
• Usually remains stationary for the majority of the day.
• Frequently communicates with clients and coworkers and must be able to share information effectively.
• Occasional stooping, reaching or kneeling may be necessary to reach into overhead or low cabinets.
• The employee must occasionally lift and/or move up to 25 pounds.
• Regularly uses close visual acuity and operates computer equipment to prepare and analyze and transmit data.
• Generally, works in an office environment.

Work Environment The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

The noise level in the work environment is usually moderate depending on business activity of the office.

Supervisory Responsibilities

This job has no supervisory responsibilities.