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Wellforce Corporate Compliance Specialist in Burlington, Massachusetts

The Compliance & Internal Audit Department audits, investigates and educates about compliance related matters that include a) billing and documentation requirements, b) physician and vendor relationships, c) patient quality and safety, and d) policies and regulations. The Corporate Compliance Specialist is a valuable resource and will assist the department in promoting the Code of Conduct and raising awareness regarding standards for ethical behavior. Also, the Corporate Compliance Specialist is an asset to the team who will grow personally and professionally in our multifaceted department. This position will have strong organizational, time management, critical thinking and problem-solving skills to manage a variety of projects in a fast-paced environment. The Corporate Compliance Specialist works under the general direction of the Senior Director of Corporate Compliance.

The intent of this job description is to provide a summary of the major duties and responsibilities of this position and shall not be considered as a detailed description of all the work requirements that may be inherent in the position.

Responsibilities

  • Assists with supporting all seven elements of an effective compliance program, as defined by the Office of Inspector General (OIG), to provide a comprehensive, effective and efficient compliance program for the organization.

  • Serves as a member of the compliance subcommittees, create, participate and contribute to meeting materials (e.g., handouts, graphs, minutes, etc.).

  • Helps with investigating alleged compliance incidents, develop corrective action plans for the resolution of problematic issues and track, monitor and report on all investigation outcomes.

  • Researches, audits and/or analyzes complex data, evaluates the information and draws logical conclusions that assists management with understanding root cause issues.

  • Assists with the research, investigation, auditing, review and analysis of general compliance, billing, education and training and other matters to ensure compliance with governmental regulations and internal policies.

  • Contributes to department initiatives, such as managing the completion status of training initiatives (e.g., annual compliance training, new hire compliance training, etc.), monitoring and sharing regulatory changes, updating the compliance work plan, creating quarterly newsletter content and engaging employees during Corporate Compliance & Ethics week.

  • In coordination with management, assists to enforce compliance standards through disciplinary processes and ensure that disciplinary actions for compliance matters are consistent across the organization.

  • Support an effective compliance communication program for the organization, including promoting: (a) available resources for reporting compliance concerns, (b) use of the compliance hotline, (c) heightened awareness of Code of Conduct and (d) understanding of new and existing compliance matters and related policies and procedures.

  • Assist with the development, maintenance, and revision of policies, procedures and practices for the general compliance and operations of Tufts Medicine and its related activities to prevent illegal, unethical, or improper conduct.

  • Obtain a clear knowledge and understanding of federal and state regulations, such as Centers for Medicare and Medicaid Services (CMS), False Claims Act, Stark Law, Anti-Kickback Statute, and Civil Monetary Penalties Law, Fraud, Waste, and Abuse.

  • Maintain confidentiality and proper sharing of information of all materials handled within the organization.

  • Other related duties as assigned.

    Experience

  • A Bachelor’s Degree in a healthcare related discipline, business, or management information systems, or another equivalent is preferred.

  • Certification in Healthcare Compliance (CHC) desired, or willingness to obtain.

  • 1-3 years’ experience relating to healthcare compliance

  • Ability to function with limited assistance within a fast-paced, dynamic and growing environment.

  • Motivated self-starter with demonstrated attention to detail and strong personal accountability.

  • Ability to manage multiple projects and duties while delivering accurate, concise, timely, exceptional and thorough work products that require no more than minor revisions.

  • Demonstrate strong analytical, critical thinking and problem-solving skills.

  • Embrace feedback and use it to develop and diversify personal and professional growth.

  • Strong desire to continue to expand skill sets and experience, as well as willingness to take on new projects and challenges.

  • Exceptional communication, writing and interpersonal skills to professionally and effectively interface with individuals at all levels of the organization, as well as multidisciplinary teams, patients and external agencies.

  • Excellent computer skills (e.g., Internet, Microsoft Office, Epic). Advanced Excel skills are desired.

  • Proven experience working in highly confidential environment with ability to multitask and manage competing priorities

  • Complies with Tufts Medicine and departmental policies regarding attendance and dress code.

  • Attends meetings, training and in-services as required.

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