Senior Compliance Analyst - Office of Institutional Compliance

Minimum Qualifications:

A bachelor’s degree and four (4) years of experience in an audit or investigation function are preferable.

Job Summary:

To audit and/or review complex systems or operations in order to evaluate and report on compliance matters and the adequacy, effectiveness, and comprehensiveness of compliance, accounting, management, or other controls in these operations and to ensure compliance with applicable federal and state laws, rules, and regulations.

Job Duties:

·         Coordinates and conducts audits of compliance activities of UTMB departments for the Office of Institutional Compliance (OIC) to ensure compliance with applicable federal and state laws, rules, and regulations.

·         Audits include compliance monitoring for the Office of Institutional Compliance, internal control, self-monitoring activities, internal education activities, investigational, and billing and coding audits with general supervision by the Chief Compliance Officer.

·         Perform specialized regulatory compliance review and analysis for the Office of Institutional Compliance.

·         Interacts with business administration department heads on a routine basis and establishes good work relations.

·         Keeps OIC attorneys and Executive Director(s) informed of audit progress, analysis results, and efficiently manages analysis and review so that departmental quality management standards are met.

·         Provides information or advice to the OIC attorneys and Executive Director(s) on regulatory compliance matters.

·         Formulates ideas and finds alternative solutions to problems and improves UTMB’s processes in ensuring the institution’s compliance with applicable state and federal laws, rules, and regulations.

·         Completes other job-related functions and special projects as assigned by the Chief Compliance Officer.

Functional Specialty Responsibilities:

(One or more of the following specialty areas may be assigned based on organizational need and employee expertise.)

Fraud & Abuse Hotline/Investigations:

·         Coordinates and conducts investigations of compliance matters on behalf of UTMB for the Office of Institutional Compliance to ensure compliance with applicable federal and state laws, rules, and regulations.

·         Investigations for the Office of Institutional Compliance, including collection of data/information, reviewing of documents, conducting interviews, compiling relevant information, and making recommendations on any findings.

·         Maintains case files, documentation, data entry, and related records in accordance with institutional standards and confidentiality requirements.

·         Coordinates meetings, communications, follow-ups, and status updates related to compliance reviews and case management activities.

·         Monitors case activity, supports timely follow-up, and assists with reporting, trend analysis, and process improvement initiatives.

HIPAA/Privacy Compliance:

·         Assists with monitoring and reviewing compliance with HIPAA, privacy regulations, in