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Vice President of Compliance - NJ

IT Security
Ref: 304 Date Posted: Sunday 26 May 2019
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Elevation Search Solutions is actively seeking a Vice President of Compliance. Our client is a rapidly growing behavioral telehealth company delivering care primarily to seniors in rural geographies across 26 states. The Vice President of Compliance will report to the Chief Executive Officer. 

What you will be doing:

The Vice President of Compliance drives the development, implementation, and maintenance of system-wide compliance, quality, privacy and security programs, policies, and procedures.

Policy & Procedures

  • Maintain knowledge of current and proposed laws, regulations and guidelines; evaluate the effectiveness of corrective action plans
  • Maintain an understanding of and assure compliance with federal and state regulations and accrediting agency standards such as CHQI, NCQA, JCAHO.
  • Proactively look for and identify opportunities to better align our clients with the requirements of healthcare laws and regulations
  • Participate with senior management in the establishment or revision of internal control procedures to ensure that adequate protection of the Company is maintained in the areas of data privacy and security and contract terms as it applies to HIPAA.
  • Initiate, maintain, and revise policies and procedures for the general operation of the quality and compliance program and its related activities to help prevent illegal, unethical, or improper conduct and to assure an ongoing continuous improvement process company-wide
  • Ensure compliance to relevant internal policies & procedures once established by legal counsel
  • Work with the Human Resources department and clinical compliance and others as appropriate to develop effective compliance training programs, including appropriate introductory training for new employees as well as ongoing training for all employees
  • Develop and maintain the quality program and compliance program for the company, including development of a program descriptions, annual evaluation, and relevant key performance measures.

Accreditations

  • Accreditations may include URAC, JCAHO, NCQA, ASWB ACE, ANCC, ISO 27002, HITRUST, SOC2 and/or others as decided from time to time by the company
  • Coordinate the Company’s activities to achieve these accreditations per approved timelines

Audits

  • Develops, maintain & execute the Internal Audit Plan based on compliance plan
  • Execute flexible and adaptable risk-based audit plans focusing on areas relevant to the healthcare industry; collaborate with Privacy and Security team and key executives to develop a compliance audit plan that identifies and prioritizes areas of significant compliance risk
  • Completes quality and  regulatory compliance audits to ensure that functional activities are conducted in accordance with Company plans, policies, procedures, accrediting body requirements  and applicable Federal and State regulations
  • Identify potential areas of compliance vulnerability and risk; develop & implement corrective action plans for resolution of problematic issues, and provide general guidance on how to avoid or deal with similar situations in the future
  • Manage multiple concurrent audits, process flows and effectiveness of control design; assess the impact of non-conforming results across the audited activity
  • Prepare for and act as the client’s main point of contact for external (e.g. client, government) audits
  • Ensure audits deliver high-quality reports and solid conclusions; provide input into the annual audit schedule
  • Drive & track audit remediation milestones per remediation plans communicated internally or with clients

Other Responsibilities

  • Perform special projects and analyses as directed by the Executive Management
  • Drive the root cause analysis and corrective/preventative action plans as well as the formal documentation of all incidents (major defects, security and/or privacy incidents)
  • Establishes and provides direction and management of the organization’s Compliance hotline. Monitors a log/tracking systems for all Confidential Disclosures through the hotline
  • Collaborates with other departments to direct compliance issues to appropriate existing channels for investigation and resolution. Monitors compliance activities of other departments to remain abreast of the status of all compliance activities and to identify trends. Consults with legal counsel as needed to resolve difficult legal compliance issues
  • Maintain a regular contact with client’s executive team and departmental heads to promote compliance to quality, security & privacy throughout the organization as established by legal counsel
  • Formally report activities compliance activities to Executive Management
  • Coordinate with internal departments to establish quality performance metric and measurement methods
  • Ensure that the continuous improvement process is in place for all areas of quality found lacking
  • Prepares quarterly reports to the Audit and Compliance committee and Senior Management detailing compliance initiatives throughout the year as well as recommends improvements/changes in the overall compliance program
  • Monitors the performance of the Quality and Compliance Program and related activities on a continuing basis, taking appropriate steps to improve its effectiveness, including periodically reviewing and updating the Standards of Conduct to ensure continuing currency and relevance in providing guidance to management and employees
  • Coordinates with legal counsel in response to identified compliance questions, concerns, or federal/state inquires or investigations
  • In coordination with the executive team, revises the compliance program to improve its effectiveness or in response to changing organizational needs or new/revised regulations, policies, and guidelines

What you need to have:

  • JD strongly preferred. Master's degree or above in a relevant field also considered and/or certifications in healthcare management
  • 8-10+ years’ experience in monitoring compliance and quality measures in the healthcare field
  • Extensive understanding of Medicare and Medicaid programs
  • Knowledge of accrediting body requirements and experience in assuring compliance with accrediting body standards
  • Knowledge of federal and state laws and regulations appropriate to the privacy and security of protected health information and personal identifiable information
  • Knowledge of the principles and practices of quality and risk management
  • Experience with healthcare software companies preferred
  • Extensive knowledge of mental health diagnostic and procedural coding principles and guidelines
  • Experience with telehealth companies preferred
  • Ability to communicate effectively with others, orally and in writing
  • Ability to work effectively with a broad range of individuals, including other employees and the public
  • Demonstrate personal traits of a high level of integrity, team orientation, professionalism, and trustworthiness. Places a high value on ethical standards and treating others with dignity and respect
  • Ability to work under pressure and handle issues which develop unexpectedly
  • Skill in analyzing and evaluating information and data and reaching sound conclusions