JOB SUMMARY
- The Corporate Compliance and Privacy Officer oversees the Corporate Compliance Program functioning as an independent and objective body that reviews, promotes and evaluates compliance issues/concerns within the Good Shepherd Rehabilitation Network. The position ensures the Board of Trustees, management and employees that Good Shepherd achieves consistently high levels of compliance with all laws and regulations while supporting the mission and business goals of the organization. Also, the position ensures that Good Shepherd’s policies and procedures are being followed and that behavior in the organization meets Good Shepherd’s Code of Conduct.
ESSENTIAL FUNCTIONS
- CORPORATE COMPLIANCE OFFICER (GSRN AND GSPP)
  - Monitor GSRN Corporate Compliance Line and GSPP Navex system as well as electronic event reporting systems for compliance concerns and issues.
  - Triage all compliance complaint/reports.
  - Investigation of complaints and reports as warranted.
  - Chair of GSRN and GSPP Ethics and Compliance Committee Meetings.
    - Each Committee meets quarterly
    - Preparation of agenda and meeting minutes.
  - Quarterly report to the Executive Committee of the Board of Trustees.
  - Preparation of Corporate Compliance Plan for GSRN and GSPP.
- PRIVACY OFFICER
  - Privacy Officer for GSRN and GSPP.
  - Review of all reported HIPAA breaches/concerns.
  - Investigation of HIPAA breaches/concerns as warranted.
  - Conduct breach assessments.
  - Notification of Cyber/Privacy insurer(s) of any actual or potential claims.
  - Work with IT Security and/or breach counsel when necessary.
  - Government reporting of HIPAA/Privacy breaches.
  - Responsible for policies related to HIPAA, confidentiality, etc.
  - Education modules.
- ADDITIONAL RESPONSIBILITIES
  - Oversees the day-to-day functions of the corporate compliance and privacy programs.
  - Review all company compliance and privacy related policies to ensure GSRN is meeting requirements with regulatory guidelines.
  - Monitors developments and changes in statutes and court rulings, rules, and regulations that impact compliance areas.
  - Creates and implements new compliance and privacy policies and procedures in response to regulatory changes and external reviews.
  - Manages compliance education and training programs.
  - Collaborates with other departments to direct compliance issues to appropriate existing channels for investigation and resolution.
  - Manages all required breach determination and notification processes under applicable Federal (including HIPAA) and State breach rules and requirements.
  - Ensures proper hospital reporting of violations or potential violations to duly authorized enforcement agencies as appropriate and/or required.
  - Ensures, in collaboration with the Contract Manager and Management, that all Business Associates execute Business Associates Agreements and maintain privacy requirements and responsibilities.
  - Advises management on business relationships and contracts from a compliance perspective.
QUALIFICATIONS:
- To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
  - Education
    - Bachelor's Degree required
    - Master's Degree preferred
  - Work Experience
    - 10+ years' experience in the Medicare managed care and/or pharmacy benefit management environment. Understanding of all applicable CMS Medicare.
    - Responsible for compliance with all federal, state and local laws, rules and regulations affecting Company and client related business.
  - Licenses / Certifications
    - Compliance Certification and Healthcare Privacy Certification required. (Required attainment within 12 months of hire into the role)
    - Knowledge and experience in state and federal information privacy laws.

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