Job Summary:
The Compliance Program Manager is responsible for reviewing and implementing the corporate compliance program, ensuring primarily that the organization maintains operational compliance in the areas of billing and coding, Health Insurance Portability and Accountability Act (HIPAA) rules and regulations, and other internal programs and policies.

Responsible for ensuring EmergeOrtho remains compliant with all applicable laws, rules, and regulations and requirements. Responsible for the execution and maintenance of the company's compliance program, including managing and coordinating the company's internal auditing process and procedures.

Duties/Responsibilities:

Monitoring and administering compliance with local, state, and federal regulators.
Responsible for coordinating visits by regulators to sites and acting as a liaison to government agencies.
Investigating potential violations and taking appropriate actions to correct them.
Work with appropriate providers, managerial-level practice staff, and employees to promote compliance and ensure top performance.
Follow all safety procedures and policies in carrying out his/her duties and responsibilities, and must also support a culture of great customer service and high quality in the organization.
The Compliance Program Manager is responsible for carrying out complex healthcare audits, such as the establishment of objectives, goals, quality measures, and timelines for the team's activities in a timely manner.
Conducting reviews of compliance work following established compliance plan(s), appropriate standards, metrics, and prescribed program and departmental policies.
Responsible for administering and maintaining various compliance technology solutions, including Hotline, Risk Assessment software, Audit/Monitoring, compliance committee documentation, exclusion/sanction screening, and learning management system.
Organizing and maintaining compliance regulatory files and team notebooks.
Assist in development of an Executive Compliance Committee.
Involved in documenting confidential investigations of alleged misconduct, breaches of policy, and other cases of non-compliance.
The Compliance Program Manager is also involved in developing and maintaining compliance-related training and educational materials.
Carry out assessment of healthcare compliance policy and procedure and assist in updating or developing new policies to enhance operations or/and internal controls or to consider new areas
Carry out risk analysis on healthcare compliance, discover areas of potential compliance risk and vulnerability, and create and implement solutions to eliminate the potential risks
Supervise regular compliance training of employees in areas such as Physician Payment Sunshine Act, HIPAA, OSHA, fraud and abuse, and other state laws to get employees informed on ethical and legal standards
Be informed of current legislation and enforcement issues affecting the healthcare industry, as well as compliance best practices.
Work closely with others in related departments, including legal, HR, IT, and Finance for effective investigation, resolution, reporting, and remediation of compliance issues.
Involvement in due diligence activities of prospective provider office acquisitions or other business ventures.
Compile and report trends from external agencies and previously identified concerns
Statewide travel as needed to regional meetings as well as conferences and training
Other duties to include but not limited to the following:

Has access to and knowledge of extremely sensitive, private and confidential materials- ability to maintain the highest standard is required with zero tolerance
Participates in professional developments efforts to ensure currency in health care policies and trends
Maintains detailed knowledge of practice management and other computer software as it relates to job functions
Attends annual Compliance, Coding/Auditing, OSHA, or other designated training programs
Attends required meetings and participates in committees as requested

Performs all other tasks and projects assigned by the Chief Compliance Officer