Specialist Senior, Compliance

We are recruiting for a motivated Specialist Senior, Compliance to join our team!

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Department

Enterprise Compliance Services

Job Summary

Under general supervision of the Compliance Manager, the Senior Compliance Specialist will assist with and support the compliance program activities of Denver Health (DH). This position supports the assessment, development, execution, monitoring, and ongoing maintenance of compliance activities such as policies and procedures, education and training, compliance hotline reports and investigations, conflicts of interest, and sanction screenings. The Senior Compliance Specialist conducts research and provides guidance related to state and federal laws and regulations which may include giving specific guidance to management, operational leadership, and departments. This position also assists in the development and rollout of compliance trainings and initiatives and monitor and report the status of completion. They are expected to work with external customers and vendors, as well as internal departments and staff throughout Denver Health to complete assigned duties and tasks.

Essential Functions:

• Develop, revise, distribute and track policies, procedures, and other key documents as part of the Compliance Program. (10%)
• Collaborate with colleagues, providing strategic guidance on programs, initiatives and processes that have healthcarecompliance-related implications to facilitate proactive compliance. (5%)
• Maintain logs of compliance inquiries and activities. Track research and disposition of compliance issues. May be asked toresearch and respond to routine compliance questions. (5%)
• Assist with the development and maintenance of forms, notices, and associated materials to reflect organizationalprocesses as well as compliance. (5%)
• Proactively identify potential issues, support risk assessments and audits, and develop work plans to monitor and addressidentified risks. (5%)
• Assist with and/or lead monitoring activities for compliance with applicable laws and regulations and internal policies andprocedures. (5%)
• Assess compliance-related educational needs and develop, implement, maintain, and oversee training programs forcompliance issues for the organization, including, for example, new employee orientation, annual online training,department or issue specific training. (5%)
• Read, understand, and maintain current knowledge of complex federal and state laws, regulations, rules, and bulletinsapplicable to the Compliance Program. (5%)
• Assists with external audits/special project preparation and follow-up, as needed, under the director of the DHMPCompliance Manager. (5%)
• Process and follow-up on Compliance Hotline reports and conducting investigations of reported compliance concerns. (5%)
• Coordinate with the Special Investigations Unit on potential fraud, waste and abuse issues and investigations. (5%)
• Coordinate responses to identified compliance questions, concerns, or federal/state inquiries or investigations. (5%)
• Evaluate excluded provider and vendor sanction screening results against state and federal databases, monthly. (5%)
• Evaluate first tier, downstream and related entities compliance with specified requirements initially and annually. (5%)
• Monitor compliance dashboards and identify potential risks based on the results. (5%)
• Participate and provide input, and support in the daily functional requirements of the organization’s Compliance Program. (5%)
• Build, develop, and maintain strong business relationships with colleagues on team and business and technology partners. (5%)
• Support corrective action plan development and management. (5%)
• Assist with other departmental projects and tasks, as required. (5%)

Education:

• Bachelor's Degree Required

Work Experience:

• 4-6 years Five years of experience in a healthcare compliance or legal function preferably in the hospital, provider or health plan setting required. Required

Licenses:

Knowledge, Skills and Abilities:

• Strong business acumen and ability to navigate effectively in a dynamic and matrixed organization
• Knowledge of laws (Federal and State Anti -kickback Statutes, False Claims Act), regulations, industry guidance and best practices regarding compliant.
• Excellent organizati