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Compliance, Privacy & Regulatory

Putting Integrity Into Practice

Promoting honesty and integrity across our daily actions and interactions, our compliance, privacy, and regulatory professionals provide the guidance and resources to uphold the highest ethical standards.

Area Compliance Officer

Location: Roseville, CA Job Number: 645042 Date posted: 01/19/2018
Description: Serves as the Hospital & Health Plan Compliance Officer, the Privacy Officer, & as a member of the Medical Center Leadership team. Responsible for the strategic development, Implementation & evaluation of compliance mgmt systems at the Medical Center, including contract hospitals, contract svcs, & other non-KFH facilities. Analyzes legal, regulatory, licensing & accreditation requirements & their impact on operations & oversees the development of compliance risk mitigation & corrective action plans. Ensures that controls are in place to guarantee privacy & security, to identify fraud, waste & abuse & to ensure that state & federal regulations are addressed. Collaborates w/ Medical Center leadership to ensure that operating procedures, systems & standards align w/ compliance requirements & controls & that staff is trained on these controls. Creates & manages detailed audits of Health Plan ad Hospital managed svcs. Develops strong collaborative leadership relationships w/ TPMG, external regulatory agencies & accreditation bodies, & uses these relationships to manage risks & establish priorities & plans to address these risks.

Essential Functions:
  • Supports the Principles of Responsibility by maintaining the privacy & confidentiality of information, protecting the assets of the organization, acting w/ ethics & integrity, reporting non-compliance, & adhering to applicable federal, state & local laws & regulations, accreditation & licensure requirements.
  • Ensures that the Medical Center has systems in place to achieve compliance by development of compliance mgmt systems (such as training, policies, procedures, monitoring & auditing, among others) across all functions.
  • Assists managers to adopt a culture of compliance in their daily operations.
  • Oversees the development, implementation & evaluation of corrective action plans & responses to internally & externally identified compliance issues.
  • Creates & manages detailed on site audits of Health Plan & Hospital managed svcs.
  • Co-leads the Medical Center Compliance Committee w/ TPMG partner & provides direction in establishing legislative & regulatory compliance strategy.
  • Develops an audit plan & dashboard to communicate completion of corrective actions to senior leadership.
  • Serves as the Privacy Officer & oversees systems to ensure the protection & security of member & patient health information.
  • Ensures the integrity of the regional hotline process & conducts investigations to resolve compliance issues & complaints.
  • In conjunction w/ Medical Center & Regional leaders, ensures that medical center service delivery changes meet requirements of state & federal regulators as well as billing requirements of Medicare & other federal coverage guidelines.
  • Oversees medical center responses to external regulatory agencies such as CMS & the Federal Office of Civil Rights.
  • Ensures that externally reported data adheres to federal & state rules.
  • Manages identified privacy breaches to ensure that all reports are filed, root cause analysis is performed & that controls are initiated to prevent further loss of protected health information.
  • Partners w/ the AFO in the development of a Fraud Waste & Abuse program that ensures internal controls are capable of preventing & detecting significant instances or patterns of illegal, unethical or improper conduct.
  • Partners w/ the Support svcs Asst Administration on environmental health & safety programs & ensures that the environment of care provided is safe, functional, supportive & effective for the delivery of patient care & safety.
  • Job description not all encompasing.

  • Basic Qualifications:
  • Minimum eight (8) years of experience in hospital operations or multifaceted health care systems and multi-provider settings.
  • Bachelor's degree in health care administration, business or public health administration, operations research, nursing, economics or other related field required, OR four (4) years of experience in a directly related field.
  • High School Diploma or General Education Development (GED) required.
    License, Certification, Registration
  • If applicant does not have the CHC, then must complete within 12 calendar months of hire.

    Additional Requirements:
  • Experience in revenue cycle program development and strategic planning required.
  • Demonstrate knowledge of accreditation and licensing requirements including but not limited to: The Joint Commission, NCQA, Knox Keene Act, CMS, Cal-OSHA, HIPAA, MEDI-Cal regulations and standards.
  • Demonstrate skill collaborating with multiple groups to achieve change.
  • Demonstrate ability to balance priorities and manage risks.
  • Able to influence Senior Leadership.
  • Must be able to work in a Labor/Management Partnership environment.

    Preferred Qualifications:
  • Master's degree in business, health care, public administration, JD or related field preferred.
  • Certified in Healthcare Compliance (CHC) or other equivalent compliance certification preferred.
    Primary Location: California,Roseville,Roseville 1680 E. Roseville Parkway 1680 E Rosevil Scheduled Weekly Hours: 40 Shift: Day Workdays: Mon - Fri Working Hours Start: 8:00am Working Hours End: 5:00pm Job Schedule: Full-time Job Type: Standard Employee Status: Regular Employee Group/Union Affiliation: Salaried, Non-Union, Exempt Job Level: Director/Senior Director Job Category: Compliance / Privacy / Regulatory Department: Corporate Compliance Travel: Yes, 10 % of the Time
    Kaiser Permanente is an equal opportunity employer committed to a diverse and inclusive workforce. Applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), age, sexual orientation, national origin, marital status, parental status, ancestry, disability, gender identity, veteran status, genetic information, other distinguishing characteristics of diversity and inclusion, or any other protected status.

    External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with federal and state laws, as well as applicable local ordinances, including but not limited to the San Francisco and Los Angeles Fair Chance Ordinances.
  • About Compliance, Privacy & Regulatory Careers

    Compliance, Privacy & Regulatory Careers

    We've established a comprehensive, world-class compliance, privacy, and regulatory program, giving you the chance to make a difference in the lives of millions. As a member of this team, you'll engage with internal stakeholders to foster an environment of safety and trust for our members, physicians, and employees alike.

    Helping to establish and maintain an effective compliance program, you'll ensure that we operate according to the highest ethical standards and follow all applicable laws, standards, policies, and procedures. Everything we do — from developing policies and training to protecting privacy and security — reinforces our commitment to our members, regulators, and the communities we serve.

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