Job Description

Job Details
Adelante Healthcare Center Support Office - Phoenix, AZ
Full Time
Bachelor's degree
Health Care

POSITION SUMMARY

The Compliance and Contract Manager will develop and oversee the Adelante Healthcare Inc. corporate compliance program, functioning as an independent and objective body that reviews and evaluates compliance issues/concerns within the organization. Will serve as the main point of contact on matters related to contract administration, compliance matters, and will oversee contact management systems. Oversees corporate compliance plans and activities, promotes staff and organizational compliance and risk management through ongoing education. The position informs the Board of Directors, management and employees of regulations and ensures organization is operating in compliance with all federal and state requirements that the necessary company policies and procedures are in place. Position contributes to drafting, negotiating and execution of contracts and other legal agreements.

EXPECTATIONS

Every Adelante Leader will strive to maximize the performance and contribution of each team member to Adelante Healthcare and the community that we serve every day. Leaders will set clear performance expectations, provide on-going feedback and coaching to improve results and outcomes and provide regular performance evaluations. Leaders are also expected to work in a manner that demonstrates a commitment to quality, patient safety, employee engagement, innovation and model for all other employees the highest standards of personal integrity, professionalism and competence.

OUR CORE VALUES

  • Compassion
  • Excellence
  • Integrity
  • Learning
  • Respect
  • Sustainability

ESSENTIAL SKILLS AND EXPERIENCE:

  • BA or BS, preferably in Business, Finance, or healthcare related field
  • Technology savvy, especially Microsoft products, Excel, Powerpoint, Word, as well as SharePoint, and experience with an Electronic Medical Record (EHR)
  • Three to five (5) years' experience in healthcare preferred, including significant experience in corporate compliance
  • Three (3) years or more experience with contract management
  • Knowledge of HRSA, FTCA, and TJC requirements
  • Knowledge of Stark, Anti-Kickback, HIPAA, HITECH and state privacy laws
  • Knowledge of healthcare compliance regulations including HIPAA Privacy, Coding, Billing, Exclusions, Investigations and Corrective Action Plans.
  • Excellent analytical, organizational and interpersonal skills
  • Valid Level One Fingerprint Clearance Card issued by the Arizona Department of Public Safety for all specialty behavioral health locations

POSITION REPONSIBILITIES/ESSENTIAL:

  • Oversees development, implementation, maintenance, posting and adherence of and to the organizations policies and procedures in compliance with federal and state laws and regulations as well as ethical standards, including any related to privacy and information security
  • Drafting and maintaining up to date policy and procedures. Primarily focusing on ensuring that all Policies & Procedures are current and following the necessary steps in posting for all employees to access
  • Ensuring that AHC conducts its activities in compliance with all federal, state, and local laws and regulations and in conformance with the highest standards of business integrity
  • Designing, implementing and maintaining AHCs compliance program employees, management, and board members achieve these objectives by establishing general overall framework for conducting our activities with integrity and accountability pursuant to a shared set of ethical and legal principles
  • Monitoring AHC is compliant with all of its contracts and agreements including but not limited to CMS; CMS Medicare Shared Savings Program; risk contracts, Commercial payer arrangements; Employer; Vendor and Consulting contracts
  • Assist management and legal counsel with contract development and management to ensure compliance with applicable licensure requirements, laws and regulations
  • Collaborating with partner organizations regarding local policies that support compliance activities
  • Overseeing all day-to-day aspects of the compliance program
  • Review the handling of Subpoenas that requires Custodian or records signature and release
  • Develops and maintains a compliance auditing/monitoring plan for the organization based on an objective organizational risk assessment. Identifies potential areas of compliance vulnerability and risk
  • Develops action plans on all identified risks and monitors the progress
  • Partners with the People Services department for annual renewal and education of Code of Conduct for all staff
  • Facilitates with department leaders on corrective action plans for any issues that may need to be resolved and monitored
  • Documents all corrective action and reports these findings quarterly to the Compliance Committee of the Board
  • Work with People Services to monitor enforcement of compliance expectations through appropriate disciplinary action
  • Responsible for gathering board documents as requested and will sit on committees as needed or directed
  • Promote and maintain a culture of open communication and professionalism by following Adelante Healthcares Code of conduct
  • Develop, publicize and maintain a reporting/tracking system whereby employees can report compliance issues and concerns without fear of retaliation
  • Respond to incidents and requests for review of cases identified by staff, patients or third parties. Facilitate the investigation and resolution of any issues identified
  • Serves as the compliance manager by reading and analyzing moderately complex contacts, researching and preparing draft contract specifications, policies, and procedures, interpreting contract requirements to contractors, and recommending contract changes based on observable needs
  • Oversees the development, revision, and implementation of policies and procedures related to contact administration and compliance program
  • Review contracts to ensure compliance with federal, state, and other regulations
  • Assist management and legal counsel with contract development to assure compliance with applicable licensure requirements, laws, and regulations
  • Provide guidance to staff on awarded terms, conditions, and regulations, as well as assist in negotiating the terms and conditions of agreements with clients, contractors, and sub-awardees
  • Reviews draft contracts and grant agreements, and modifications to such agreements, to ensure adherence to regulations and corporate, programmatic, compliance and financial interests are considered and represented in such agreements
  • Prepare contract related templates including those for solicitation, contracts, consulting agreements, and purchase orders
  • Develop and maintain operational, procurement and record-keeping systems for efficient performance and audit records of client contracts and agreements
  • Identifies issues that require input from and/or approval of Legal Services and referring these issues for legal review and resolution. Assist legal services in analyzing AHC-related legal an compliance issues
  • Ensures the ability of AHC to provide documentation when requested by federal, state, local, and internal auditors by maintaining records for review
  • Maintain records of contracts and other legal agreements
  • Exchanges information by relaying information accurately and assuring information is communicated in a timely manner
  • Provides required or requested information and/or data for internal or external reports and records by researching department files and records, retrieving electronic data from files and databases, researching online sources, compiling information and/or tabulating statistics, and organizing and presenting the information in a useable and understandable format
  • Work with departments to develop new policies and procedures to implement compliance requirements
  • Review all results and compliance related information from audit requests from external entities, including CMS, HRSA, Commercial payers, etc.
  • Maintains a strong awareness of existing laws and regulations affecting AHC while keeping abreast of current changes. Informs the employee population regarding these compliance matters through personal initiatives, seminars, training programs, peer contact, and other education efforts
  • Identifies issues that require input from and/or approval of Legal Counsel and referring these issues for legal review and resolution. Assists Legal Counsel in analyzing AHC related legal and compliance issues
  • Collaborates with departments and clinical areas to identify statutory and regulatory requirements and organizational policies, and notify appropriate department to facilitate the implementation of remedial measures when necessary and monitor changes have been implemented
  • Supports the submission of annual FTCA Deeming process
  • Audits site required items for all health centers
  • Responds to department requests and inquiries on legal and compliance questions
  • Facilitates the HRSA OSV process

NONESSENTIAL SKILLS AND EXPERIENCE:

  • Three (3) years of experience in a non-profit community health center

Additional Duties and Responsibilities:

  • Other duties as requested or assigned

PCMH

All employees are responsible for promoting and participating in interdisciplinary communication and collaboration to enhance the delivery of quality across the health care system. Employees should maintain an environment which supports and engages patients and co-workers in a caring team based model to promote wellness and improve health outcomes.

Adherence to Compliance and Code of Conduct

All employees are required to comply with Adelante Healthcares written standards, including its Compliance Program and Standards of Conduct, policies and procedures and reporting of any conduct that potentially violates Adelantes legal or compliance requirements. Such compliance will be an element considered as part of the regular performance evaluation.

PHYSICAL DEMANDS AND WORK ENVIRONMENT

The physical demands and work environment characteristics described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Physical demands: While performing the duties of this job, the employee may be required to sit for long periods of time, is required to stand, walk, use hands to handle or feel objects, tools or controls; reach with hands and arms; climb steps/stairs; balance; stoop, kneel, crouch or crawl; talk or hear; smell; manage stress as it relates to essential job functions. The employee must frequently lift and/or move up to 25 pounds without assistance, and may occasionally be required to lift or move up to 50 pounds with assistance. Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.

Work environment: While performing the duties of this job, the employee is exposed to weather conditions prevalent at the time when traveling to various clinic sites. The noise level in the work environment is usually moderate. The employee may be subject to health hazards (contagious diseases, blood borne pathogens, etc.) when working in the clinic area.

In any organization or job, changes take place over time. Although an effort will be made to keep job-related information current, this is not an all-inclusive list of job responsibilities. Adelante Healthcare, Inc. reserves the right to revise or change job duties and responsibilities as the business need arises. In compliance with EEOC 29 CFR part 1630, if the essential functions of this position cannot be performed in a satisfactory manner by the employee, further accommodations shall be made if it does not constitute undue hardships upon this organization.

Application Instructions

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