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Overview

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At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of jobs, and a supportive environment that enables you to reach new heights in your career and be what you want to be. We provide:

• Comprehensive health benefits that start day 1

• Student Loan Repayment Assistance & Reimbursement Programs

• Family-focused benefits

• Wellness incentives

Ongoing mentorship, development, leadership programs...and more!

Description

Director, Compliance and Privacy Operations reports to the Chief Compliance Officer of Emory Healthcare (CCO EHC) for the job responsibilities relating to Emory Healthcare Office of Compliance Programs.

• Participates in the development and contributes to the achievement of established department goals and objectives, and annual work plan.

• Acts as a resource of the organization in matters of regulatory compliance and privacy.

• Coordinates compliance operations initiatives monitoring systems and processes for compliance tracking.

• Ensures the distribution of compliance education regarding policies and procedures, the code of conduct and new regulatory updates in coordination with Director of Compliance Education.

• Assists in, directs, and coordinates the Emory Healthcare Compliance Program oversight with ownership over day-to-day operations.

• Responds to requests for guidance from operating units, departments, and staff and delegates follow-up tasks to team members as appropriate.

• Determines need for review of compliance matters that are received by the EHC OCP.

• Independently provides analysis of compliance related matters and opportunities based on sound regulatory research, and by conducting periodic reviews of applicable healthcare regulations and rules.

• Knowledgeable in compliance matters including clinical activities, coding, billing, patient privacy, reimbursement, risk management, and strong familiarity with the applicable laws and regulations for hospital and physician practices.

• Directs internal investigation of patient privacy matters.

• Provides oversight of privacy reviews and investigations.

• Directs privacy breach risk analysis and notifications.

• Directs breach disclosure data to DHHS in accordance with the Privacy Rule.

• Collaborates with Emory University Office of General Counsel and outside counsel as needed.

• Drafts and finalizes policies related to privacy and compliance operations.

• Directs investigations in response to the Office for Civil Rights (OCR) inquiries and investigations.

• Facilitates document request between Office for Civil Rights (OCR) and Emory University Legal Counsel.

• Directs review of Business Associate Agreements and questions, and document revision.

• Independently or collaboratively conducts investigations, summarizes results, and makes recommendations when indicated by audit results.

• Working with Internal Audit and Enterprise Risk Management to execute the Annual Enterprise Risk Assessment.

• Partners with Operational leadership as appropriate on the implementation of policy and procedures as well as education of departments deemed to have need in relation to compliance and privacy issues.

• Assists Patient Relations and the Risk Management departments with patient letters and communications around HIPAA/Privacy allegations.

• Works with the Director, Compliance Coding and Billing Audit and Analysis on billing reviews and refunds.

• Develops/reviews and updates policy & procedures as needed or requested.

• Works with CCO EHC across various compliance and privacy matters.

• May work independently or at the direction of the CCO EHC.

• Manages or leads advanced investigations to include submission of findings, complying with notification requirements, and works with the operating unit/HR on potential corrective actions.

• Monitors, assesses, and prioritizes key compliance risk areas and proactively works to identify major enterprise-wide compliance risks.

• Leads compliance investigations on alleged violations of rules, regulations, Code of Conduct, and policies; evaluates and recommends investigations, as appropriate.

• Coordinates the resolution of compliance investigations.

• Maintains strong awareness of federal and state laws, regulations, guidelines and Federal Health Care Program payment and reimbursement requirements, False Claims Act and changes that may affect the organization.

• Participates actively in developing and implementing ethical business practices.

• Provides oversight of compliance activities and real-time guidance related to compliance issues to business units across EHC.

• Directs the coordination and completion of government and regulatory requests for documents.

• Manages large scale compliance projects and initiatives to completion.

• Interacts with other department leaders.

• Other duties as circumstances and events warrant (e.g., special projects etc.).

• Assists in drafting Management Compliance Committee (MCC) and Audit & - - Compliance Committee (ACC) meeting materials and reports.

• Provides oversight of compliance activities and real-time guidance related to compliance issues.

• Reviews and provides guidance on Conflict of Interest(COI) and Conflict of Commitment(COC).

• Coordinates documentation of management action plans for identified COI/COC and drafts materials for review by COI Management Committee.

• Provide guidance for workforce members in relation to anticipated vendor relations.

• Facilitates EHC annual COI disclosure Emory entities. Reviews annual disclosure statements to identify potential COI concerns reported by workforce members.

• Conducts COI investigations and develops reports/data analysis to provide to leadership.

• Review and update COI policy periodically.

• Coordinates the Emory Trust Line (Hotline) and ensures that concerns have been addressed through effective follow-up in accordance with policies and procedures.

• Runs reports as requested by leadership.

• Coordinates distribution of reported concerns to appropriate operating unit as needed.

• Promotes use of the Emory Trust Line and develops campaigns for employee awareness of platform.

• Coordinates with Emory/EHC HR on matters as needed.

• Coordinates with EU Compliance on matters as needed.

• Partners with Risk Management for awareness of SAFE reports that may have privacy and/or compliance violations and have a need for education.

MINIMUM QUALIFICATIONS:

• A bachelors degree in healthcare or business-related field. Master's degree preferred.

• Seven (7) years experience working in the healthcare compliance environment with preference in an Academic Medical Center.

• Experience in conducting investigations, performance of compliance audits and reviews, in depth knowledge of healthcare compliance and privacy laws, regulations, and guidance.

LICENSE/CERT/REG:

Certification in healthcare compliance or another comparable compliance certification from a recognized industry professional association with a focus on regulatory compliance, auditing, monitoring, etc.

KNOWLEDGE, SKILLS, ABILITIES:

• Strong written and oral communication skills.

• Strong analytical and problem-solving skills.

• Proficiency in working with Microsoft Office products and other healthcare applications.

• Proven ability to manage multiple projects and deadlines. Strong people management skills.

• May be required to travel to various operating units locations.

POSITION: Hybrid, in office 2-3 days per week

Additional Details

Supporting a diverse, equitable and inclusive culture. Emory Healthcare (EHC) is dedicated to providing equal opportunities and access to all individuals regardless of race, color, religion, ethnic or national origin, gender, genetic information, age, disability, sexual orientation, gender identity, gender expression and/or veteran's status. EHC does not discriminate on the basis of any factor stated above or prohibited under applicable law. EHC respects, values, and celebrates the unique perspectives and backgrounds of all individuals. EHC aspires to create an environment of collaboration and true belonging for all our patients and team members. Emory Healthcare (EHC) is committed to achieving a diverse workforce through equal opportunity and nondiscrimination policy in all aspects of employment including recruitment, hiring, promotions, transfers, discipline, terminations, wage and salary administration, benefits, and training.

ACCOMODATIONS: EHC will provide reasonable accommodations to qualified individuals with disabilities upon request. To request this document in an alternate format or to request a reasonable accommodation, please contact the Office of Diversity, Equity, and Inclusion.”

PHYSICAL REQUIREMENTS: (Medium-Heavy) 36-75 lbs., 0-33% of the work day (occasionally); 20-35 lbs., 34-66% of the workday; (frequently); 10-20 lbs., 67-100% of the workday (constantly); Lifting 75 lbs. max; Carrying of objects up to 35 lbs.; Occasional to frequent standing & walking; Occasional sitting; Close eye work (computers, typing, reading, writing); Physical demands may vary depending on assigned work area and work tasks.

ENVIRONMENTAL FACTORS: Factors affecting environment conditions may vary depending on the assigned work area and tasks. Environmental exposures include, but are not limited to: Blood-borne pathogen exposure; Bio-hazardous waste Chemicals/gases/fumes/vapors; Communicable diseases; Electrical shock; Floor Surfaces; Hot/Cold Temperatures; Indoor/Outdoor conditions; Latex; Lighting; Patient care/handling injuries; Radiation; Shift work; Travel may be required; Use of personal protective equipment, including respirators; environmental conditions may vary depending on assigned work area and work tasks.

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Division Emory Healthcare Inc.

Campus Location Atlanta, GA, 30345

Campus Location US-GA-Atlanta

Department EHI Office of Compliance

Job Type Regular Full-Time

Job Number 136151

Job Category Business Operations

Schedule 8:30a-5p

Standard Hours 40 Hours

Hourly Minimum USD $47.39/Hr.

Hourly Midpoint USD $63.18/Hr.

Emory Healthcare is an Equal Employment Opportunity employer committed to providing equal opportunity in all of its employment practices and decisions. Emory Healthcare prohibits discrimination, harassment, and retaliation in employment based on race, color, religion, national origin, sex, sexual orientation, gender identity or expression, pregnancy, age (40 and over), disability, citizenship, genetic information, service in the uniformed services, veteran status or any other classification protected by applicable federal, state, or local law.