JOB TITLE: Optim Health System- Compliance Officer, Savannah, GA
Optim Health System is seeking a Compliance Officer to be responsible for implementing, training and monitoring compliance with regulatory compliance requirements for the system’s employees, medical staff providers, and vendors utilized by the health system. The Compliance Officer will report locally to the CEO of Optim Health System. The compliance program for the Health System is provided by Surgery Partners, and the Compliance Officer will also have a matrixed reporting structure to the Surgery Partners Chief Compliance Officer. Compliance Officer Duties include, but are not limited to the following:
- Developing and implementing policies, procedures, and practices designed to ensure compliance with the requirements
- Making periodic (at least quarterly) reports regarding compliance matters to the SVP, Chief Compliance Officer of Surgery Partners
- Monitoring the day-to-day compliance activities engaged in by Optim Health System facilities and practices
- Assists with implementing the eight elements of the Surgery Partners Compliance Program at the Health System’s facilities
- The Compliance Officer will provide timely advice to Optim Health System’s operational leadership and others as needed
Optim Health System’s nationally recognized, physician-owned facilities include:
- Optim Medical Center-Tattnall, Reidsville, GA
- Optim Medical Center-Screven, Sylvania, GA
- Optim Surgery Center, Savanah, GA
- Premier Surgery Center, Brunswick, GA
- several healthcare clinics throughout southeast Georgia.
Optim Health System’s Orthopedic Centers of Excellence includes a collaborative partnership with Optim Orthopedics, Spivey Orthopedic Clinics, and other notable orthopedic practices across the region. Together this network of highly trained medical staff and board-certified, fellowship-trained physicians offer comprehensive, specialized treatment in multiple areas including orthopedics, neurosurgery, interventional pain management, general surgery, primary care / internal medicine, physical and occupational therapy, and athletic trainers.
JOB SUMMARY/RESPONSIBILITIES:
Promote Compliance to Organization
- Participate in the implementation of the Surgery Partners Compliance and Ethics Program at Optim Health System.
- Responsible for assisting in the planning, design, implementation and monitoring of the compliance program.
- Demonstrates understanding of and promote adherence to the Surgery Partners Code of Conduct, the Surgery Partners Compliance and Ethics Program and all laws, regulations, and company policies governing the delivery of quality health care services.
- Understands regulatory laws and guidelines, and partners with local management and regional leaders to provide continual risk assessment, development of comprehensive policies and procedures, compliance training, protocols, internal investigations, providing regulatory reviews & opinions and auditing and monitoring.
- Serves as a contact person for reports of concerns or potential compliance issues. Confers with management staff to identify and correct potential areas of noncompliance and anticipate future compliance requirements. Brings all reported issues to the attention of the Chief Compliance Officer.
- Coordinates the development, maintenance, implementation, and revision of policies, process and procedures and other documents for the operation of the compliance program.
- Work with Legal, Operations and other functions to assure awareness of regulatory compliance requirements applicable to Facilities provision of healthcare and related services; review and make recommendations with respect to the Facilities policies and processes related to such compliance requirements (e.g., state and local law licensing requirements).
- Supports the Optim Health System Leadership Team to address Compliance issues and questions.
Monitoring
- Possess a clear understanding of healthcare law and revenue cycle management and the ability to conduct advanced research.
- Develops and implement investigation procedures to ensure adequate and timely follow-up to all Compliance Hotline (Surgery Partners Action Line) reports and all other reports of potential compliance violations received through other channels.
- Develops an audit plan to verify compliance with Compliance Policies and Procedures by all employees, at all worksites.
- Review results of excluded person monitoring for all new employees or independent contractors in conjunction with Human Resources and coordinate responses to identified person who may be a match to an excluded person at the Federal or State level.
- In consultation with Human Resources, participate in the implementation of and promote the usage of disciplinary guidelines regarding the actions to be taken for violations of the Code of Conduct and/or Compliance policies and procedures.
- Monitor the day- to-day compliance activities of the system. Analyze statistical data and reports to identify and determine compliance issues.
- Performs compliance audits for the purpose of monitoring processes and detecting noncompliance, including coordinating audit activities and responses. Prepares audit reports and makes recommendations to the Surgery Partners Chief Compliance Officer, Hospital CEO and local management based on findings. Prepares periodic reports for management and the Optim Health System Compliance Committee.
- Reviews and updates local compliance policies, contracts and other compliance related materials to ensure they are current and relevant with all applicable federal, state, and industry laws, regulations, and standards in providing guidance to management and employees.
Compliance Education
- Provide consultation and education for Optim Health System staff impacted by compliance activities.
- Assist in the development and provision of compliance training to employees, medical staff, and independent consultants. Compile training reports to monitor adherence to training requirements.
- Performs research and analysis on Corporate and federal payer rules, regulations and transmittals and communicates requirements to operational areas.
Issue Tracking
- Participates in Compliance Operations Meetings and assists with the tracking and resolution of compliance issues that affect operations.
- Maintain logs of inquiries and track research and disposition of compliance issues raised by senior management, employees, business partners and external auditors
Collaboration / Leadership
- Adhere to all company policies and procedures. Practices and adheres to the “Code of Conduct” and “Mission and Value Statement”.
- Provide support to joint projects with Surgery Partners Compliance staff.
- Collaborates with operational department managers to resolve compliance or regulatory concerns.
- Communicate regularly with internal departments to ensure audit deliverables and remediation responses are submitted timely.
- Acts as a resource for compliance, government and third-party reimbursement regulations and rules.
- Provides advisory assistance regarding billing compliance matters.
- Formulate, affect, interpret, and implement compliance policies and procedures as needed.
- Assist Surgery Partners Chief Compliance Officer in risk analysis, planning, auditing and program development for compliance activities throughout Optim Health System
- Formulate, affect, interpret, and implement compliance policies and procedures as needed.
- Analyze compliance and internal process risks for all Facilities Operational areas.
- Travel (local and national) may be required periodically with this position but is not expected to exceed 25% of time now or in the immediate future.
- Other duties as assigned.
EDUCATION/REQUIREMENTS:
Bachelor's Degree in Business Administration, Health Information Management, Health Administration or similar degree. Equivalent work experience may substitute education requirements. Degrees in either Law or Accounting preferred.
EXPERIENCE/LICENSE:
Minimum 5 years’ experience as a mid level compliance professional in the healthcare industry. Valid driver’s license when driving any vehicle for work-related reasons. Certified in Healthcare Compliance (CHC) through the Health Care Compliance Association preferred.
PHYSICAL/MENTAL DEMANDS: Requires sitting and standing associated with normal office environment.
ENVIRONMENTAL/WORKING CONDITIONS: Normal busy office environment with much telephone work. This description is intended to provide only basic guidelines for meeting job requirements. Responsibilities, knowledge, skills, abilities and working conditions may change as needs evolve.
