Remote Case Manager Jobs in Portland, OR (NOW HIRING)

Description

PeaceHealth is seeking a Remote (must reside in OR, WA or AK)  Manager Healthcare Compliance for a Full Time, 1.00 FTE, Day position. The salary range for this job opening at PeaceHealth is $48.52 – $72.78. The hiring rate is dependent upon several factors, including but not limited to education, training, work experience, terms of any applicable collective bargaining agreement, seniority, etc.

Job Summary

Assists the System Director, Privacy and Integrity in developing and maintaining the Healthcare Compliance Program for PeaceHealth. Manages the team responsible for performing process-related compliance investigations; government Billing and Audit Program, annual work plan audits; and monitoring activities related to compliance across PeaceHealth and other staff as assigned. Oversees the Healthcare Compliance team's efforts in identifying, assessing, and recommending corrective actions (including analyzing root causes and controls) regarding process-related issues to help support operational compliance with state and federal laws and rules. Contributes to the development and maintenance of a compliance program in accordance with the Department of Health and Human Services, Office of Inspector General (OIG), state and local regulations. Implements and oversees an effective compliance program based upon the seven (7) elements promulgated by the OIG.

Essential Functions

• Manages all aspects of the PeaceHealth Healthcare Compliance (HCC) Program including the development, communication, implementation, monitoring, and maintenance of the program by partnering with all levels of caregivers and leaders on process-related compliance initiatives across the system.

• Manages all aspects of assigned team including – but not limited to – hiring, training, mentoring, coaching, disciplining, and evaluating performance.

• Develops and provides reports, presentations, and metrics for informing all levels of caregivers and leaders related to all facets of the Healthcare Compliance Program including both routine and ad hoc requests.

• Identifies, creates, maintains, and reports on team-related key performance indicators.

• Manages, conducts, and oversees team members on process-related investigations for compliance concerns identified by both internal and external reporters related to issues across the system.

• Performs as well as manages the team’s work-plan audits designed to evaluate compliance risks related to applicable federal, state, and regulatory agencies laws and rules including overseeing those performed by a third-party vendor on behalf of PeaceHealth.

• Acts as a liaison between the department and all levels of leadership related to corrective actions resulting from process-related compliance issues to help ensure effective and timely remediations.

• Provides guidance to the team and operational leaders and acts as a trusted advisor for controls recommendations and root cause evaluations related to corrective action plans.

• Develops and maintains a proactive monitoring program encompassing key operational compliance activities to evaluate the long-term efficacy of compliance-related controls.

• Assist and participates in the annual risk assessment process resulting in the Healthcare Compliance Annual Audit Work Plan.

• Acts as a consultant to operational leaders responsible for developing, documenting, updating, and maintaining departmental-specific compliance programs.

• Provides guidance to all levels of PeaceHealth caregivers on process and billing related compliance questions in partnership with other key areas as needed (such as legal, risk, accreditation).

• Represents the Healthcare Compliance department on committees, task forces, projects, and in various meetings.

• Performs other duties as assigned.

Qualifications

Education

• Bachelor's Degree Required: Healthcare Administration or equivalent discipline

Experience

• Minimum of 5 years Required: Relevant healthcare or other applicable compliance experience and/or clinical operations experience and

• Minimum of 2 years Required: Leadership experience and

• Required: Experience with the 7-elements of a compliance program and

• Preferred: Medical records experience and

• Preferred: Project management experience

Credentials

• Required: within 1-1/2 Yrs Certified in Healthcare Compliance

Skills

• Outstanding verbal and written communications, interpersonal and leadership skills. (Required)

• Ability to effectively communicate and interact with all levels of leadership. (Required)

• Ability to successfully navigate difficult conversations and influence staff at all levels. (Required)

• Experience creating a productive environment for, and to inspire, direct reports. (Required)

• Strong skills and experience developing and performing core compliance program functions, including: investigations, case management, pro-active auditing/monitoring, remediations (corrective actions), risk assessments, policies, education, root cause analysis, and controls assessments. (Required)

• Strong presentation, data analysis, and report creation skills including the ability to report out to all levels of PH leadership. (Required)

• Clear, intentional, and strategic communicator including helping team and other caregivers find clarity in compliance-related matters. (Required)

• Proven ability to thrive in a fast-paced changing environment and successfully manage the team while leading multiple investigations and projects simultaneously. (Required)

• Demonstrated proactiveness with the ability to work independently. (Required)

• Excellent analytical and problem-solving skills. (Required)

• Advanced skills in all MS Office applications (Word, Excel, Outlook, PowerPoint). (Required)

• Ability to travel to other PeaceHealth facilities and locations. (Required)

Working Conditions

Lifting

• Consistently operates computer and other office equipment.

• Exerting up to 10 pounds of force occasionally and/or negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects.

• Sedentary work.

Environmental Conditions

• Predominantly operates in an office environment.

• Some time spent on site in medical/hospital setting.

Mental/Visual

• Ability to communicate and exchange accurate information.

• The worker is required to have close visual acuity to perform an activity such as: preparing and analyzing data and figures; transcribing; viewing a computer terminal; extensive reading.

PeaceHealth is committed to the overall wellbeing of our caregivers: physical, emotional, financial, social, and spiritual. We offer caregivers a competitive and comprehensive total rewards package. Some of the many benefits included in this package are full medical/dental/vision coverage; 403b retirement plan employer base and matching contributions; paid time off; employer-paid life and disability insurance with additional buyup coverage options; tuition and continuing education reimbursement; wellness benefits, and expanded EAP and mental health program.

See how PeaceHealth is committed to Inclusivity, Respect for Diversity and Cultural Humility.

For full consideration of your skills and abilities, please attach a current resume with your application. EEO Affirmative Action Employer/Vets/Disabled in accordance with applicable local, state or federal laws.