Compliance Consultant V Ethics, Compliance & Fraud Control (Oakland, CA) Job in Oakland, California Us
Compliance Consultant V Ethics, Compliance Fraud Control
Kaiser Permanente
Oakland, CA
The Compliance Consultant V researches, plans, implements, and monitors a broad portfolio of compliance systems and initiatives to enable organizational compliance with all applicable Federal, state, and local regulations/laws, as well as overseeing the protection of organizational assets. On an on-going basis, researches and interprets regulations and laws to establish compliance standards, and may develop and/or deliver training and communications/change management relative to new standards. Assesses organizational systems (both physical and process or data related) to determine gaps in compliance and determine opportunities for remediation. Advises the organization on all compliance matters. May investigate violations of compliance policy, laws, regulations, etc. or conduct on-going monitoring and reporting to ensure remediation. May be responsible for project management relative to new compliance initiatives, products, or annual processes.
Essential Functions:
- Manages, creates, and maintains client relationships with management at all levels of the organization.
- In adherence with the KP Compliance Framework, fosters comprehensive compliance management through a series of activities to comply with all applicable regulations and statutes. Activities include:
- Planning: leading the identification of compliance accountabilities; identification of internal and external resources; development of Compliance, Work, and Audit plans; establishing and/or leading compliance-related committees/work groups; and managing external agency relations,
- Implementing: leading the identification of compliance requirements and directing related analyses; creation and revision of compliance standards, policies, and procedures; overseeing development and/or delivery of compliance and ethics training; leading the monitoring of compliance adherence; and directing reporting on compliance efforts and programs, and
- Validating: reviewing compliance programs and content, including leading the design and implementation of risk assessments and/or audits, and overseeing the investigation of instances of reported non-compliance.
- Researches and stays abreast of regulations and statutes.
- Determines 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.
- May engage external regulatory and legislative bodies on developing regulations and laws, providing input and representing Kaiser Permanente's interests.
Qualifications:
Basic Qualifications:
- Minimum 12 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.
- 4 year degree and Master's Degree required.
- Expert knowledge of health care compliance policies, practices and systems.
- Develops advanced compliance principles, theories, and concepts.
- Expert knowledge of health care industry practices and standards.
- Ability to draft and revise documents including policies, standards, analyses, and reports.
- Project management skills.
- Experience with quantitative research and data mining.