• Compliance Project Specialist

    Job Locations US-MD-Linthicum Heights
    Posted Date 1 month ago(12/19/2018 3:12 PM)
    Job ID
    # of Openings
  • Overview

    The Compliance Project Specialist will assist the Compliance Officer and the Director of Clinical Risk & Safety in implementing effective Compliance and Risk Management Program Plans. Under general supervision, the Compliance Specialist will perform a variety of duties centered on effective implementation of all the elements of a compliance and risk program to ensure compliance with applicable laws, rules, and regulations; internal policies and procedures; accepted business practices; ethical standards; and contractual obligations.






    • Prefer quality, quality reporting, MIPS or PQRS background
    • Create, maintain, and revise compliance policies and procedures. Work with other departments to keep the compliance and risk content of their policies and procedures up to date
    • Provide administrative support for compliance and risk/safety management committees, including creating agendas, presentation materials and minutes
    • Deploy electronic compliance, risk, and safety educational and training modules
    • Familiarity with Merit Based Incentive Payment System (MIPS) and process changes for successful value-based care improvement.  Conduct regular monitoring and reporting of individual MIPS quality measures. Educate staff on MIPS requirements and data collection in patient record.
    • Familiarity with cancer registry reporting
    • Maintain employee health and safety information, including screening documentation on hire, exposure information, OSHA injury logs, communications with TPA and occupational health provider entities, and prevention expertise and assistance.
    • Maintain quarterly logs of compliance inquiries and activities, including compliance calls, government inquiries, audits, and training. Track and trend compliance and risk issues and present related data in various formats, including dashboards. Investigate compliance and risk issues as assigned
    • Complete timely research for external government or agency reviews, subpoenas, audits, and investigations; copy and release medical records; communicate audit results; and provide implementation/corrective action assistance as warranted.
    • Participates in the annual risk assessment and development of the Compliance and Risk work plans
    • Conduct internal compliance and risk audits and reviews, communicating results and recommendations in clear and concise written reports; and collaborate with management to ensure corrective actions are implemented and effective



    Experience Requirements:

    • Ability to work collaboratively with physicians, non-physicians and staff and leaders of clinical, financial, and other departments
    • Ability to manage multiple initiatives concurrently and work independently
    • Familiarity with effective implementation of the elements of a compliance program
    • Strong analytical, communication, and presentation skills
    • Proficiency in software packages such as Word, PowerPoint and Excel

    Preferred Qualifications:

    • Physician practice plan compliance or physician office compliance experience
    • Certification in Health Care Compliance (CHC) or Graduate Certificate in Health Care Compliance
    • Medical and/or clinical background a strong plus
    • Coding certification a plus



    • Bachelor’s degree or
    • 2-yr degree in a healthcare discipline with associated license, certification, or registry


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