General Description |
Implements and manages the design, development, and implementation of the compliance, quality improvement, accreditation, and patient satisfaction activities with measurable results. Drives the compliance, quality, and accreditation processes to include policy and procedure management and organization. Collects data, prepares statistical reports and analysis to improve the services provided within Health System. Maintains strict confidentiality. Responsible for the development, implementation, and enforcement of the clinic’s compliance programs. Consults on an ongoing basis on related issues with operation managers and executives. May present status and results of programmatic activities to health board. Ensures conformance with applicable laws, regulations, and accreditation standards which may include Medicare/Medicaid reimbursement, EEO, AAAHC, Intermediate Sanctions legislation, hazardous waste disposal, ADA, etc. Plans, organizes and directs implementation of the health system strategic plan within strict adherence to the guidance and oversight of the executive director and health board, including tracking of budgeted time and dollars of these compliance programs. Will work under the supervision of the Health Deputy Director (in cooperation with the Medical Director). Position primary location is the Little Axe Health Center, but is also responsible for Shawnee Clinic compliance and quality activities. Key competencies are knowledge of Clinical Compliance Areas such as CLIA, OSHA, Fire & Safety; Working knowledge of summary of 2013 Omnibus HIPAA Final Rule information. Must have working knowledge of how to conduct Risk Assessments; Fraud, Waste, and Abuse, American Recovery & Reinvestment Act (ARRA), and FERA programs; Medical Identity Theft Compliance; Revisions to HIPAA & BAA Compliance; False Claims Act (FCA), Affordable Care Act & Impact on Health Care; Penalty structures involved for Providers, Administrators, Coders and Staff if Fraud or Abuse Charges are Raised; Whistle-blower, Qui Tam and Self Disclosure, Corporate Integrity Agreements; Anti-Kickback Statutes; Risk of Professional Courtesy; Stark Provisions & Compliance; Physician Compensation Compliance; and Managing & Assessing Risk.
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Responsibilities & Duties |
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EDUCATION Requirements and Qualifications |
Physical Requirements and Working Conditions
The Absentee Shawnee Tribe of Oklahoma (AST) is committed to Equal Employment without regard to race, religion, color, gender, national origin, age, disability, or sexual orientation. However, in accordance with the Indian Preference Act (Title 25 U.S. Code 472 and 473) preference in filling vacancies are given to qualified Indian candidates. AST will make reasonable accommodations in compliance with the Americans with Disabilities Act of 1990 and its amendments.
Native American Preference/EEO/Drug Free/Smoke Free Workplace
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