Leads, oversees, develops, implements, and maintains compliance programs and plans aimed at facilitating ethical and legal conduct, centralized dissemination of information and guidance on federal and state laws and regulations, accreditation and licensing requirements. Develops, implements, and coordinates the audit process, providing analysis and findings to the Senior Leadership. Identifies areas of risk for compliance. Develops, implements, and monitors work plans for correction. Provides clinical expertise in specific area as appropriate.
Essential Functions:
- Works as consultant and project manager on compliance issues on existing and planned operations. Participates in the development and implementation of project support regarding departmental changeovers and reorganizations
- Participates in the development and implementation of internal audits. Coordinates the audit process, including reviewing, analyzing, and reporting findings to Senior Leadership, and to compliance committees
- Provides consultation on corrective actions related to clinical and health services delivery operations
- Performs risk assessments and operation overviews of relevant hospital, clinic, and ancillary departments. Determines possible weaknesses and/or vulnerabilities as related to possible regulatory intervention activities
- Acts as consultant and project manager in the development of policies relating to compliance. Provides clinical expertise for areas of compliance which involve medical necessity and/or quality concerns
- Makes recommendations for a corrective action plan when a confirmed compliance deficiency is identified
- Participates in the development and implementation of education programs to ensure all appropriate parties are knowledgeable about their compliance responsibilities
- Performs other duties and accepts responsibility as assigned
Qualifications:
Basic Qualifications:
- Five years of project management, consulting, healthcare auditing and investigation, or related experience
- Bachelor's degree in business administration, public health, health administration, or related field
- Valid Hawaii RN license (must meet education requirement(s) for Hawaii State licensure)
- Demonstrated knowledge of related federal and state laws and regulations, hospital/clinical systems, processes, and operations
- Demonstrated ability to consult, advise, and translate customer needs into solution alternatives
- Demonstrated knowledge of and skill in change management, conflict resolution, investigation, risk assessment, decision making, group process facilitation, influence, interpersonal relations, oral communication, problem solving, project management, systems thinking, team building, and teamwork
- Must be able to work in a Labor/Management Partnership environment
Preferred Qualifications:
- Master's degree in business administration, public health, health administration, or related field
External hires must pass a background check/drug screen.
We are proud to be an equal opportunity/affirmative action employer.