Sr Compliance Consultant Job in Union City, California Us

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 moderate 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, 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 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 synthesizes complex information to develop new solutions to existing alternatives.
- Creates, develops revises basic 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:
- 5-8 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.
- Bachelor's degree or equivalent experience.
- Masters degree in Health Care Administration, Business Administration, Finance, Economics, Operations Research, Public Health or other Health Care related field preferred.
- Certified in Healthcare Compliance (CHC) or other accredited compliance certified.
- 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.

Preferred Qualifications:
- Strong computer skills i.e. Excel, Access, Microsoft Project or other programs.
- Knowledge of Regulatory requirements / regulations, related to Compliance in a Health Care settingand and Health Care delivery in general.
- Be a thought partner to HCO, provide directive input