Director of Compliance and HIPAA Privacy

Our Vision is to be the best choice for healthcare in our community

Job Title:                    Director of Compliance and HIPAA Privacy

Department:              Administration

Reports to:                 FMC Board of Directors and Chief Executive Officer

Job Summary:  Responsible for the oversight of Florida Medical Clinic’s Compliance program, to ensure compliance with federal, state, and local laws and regulations, as well as billing regulations and organizational policies and ethical standards. In addition, the HIPAA Privacy Officer will develop, manage, and implement processes to ensure compliance with applicable federal and state HIPAA regulations and guidelines, particularly regarding the access to and use of protected health information (PHI).

WHAT DOES FMC HAVE TO OFFER ITS EMPLOYEES?

We offer a wide choice of compensation and benefit programs that are among the best.  From competitive salaries to retirement plans. We make every effort to take care of the people who make our company great.

• Gives you an employer that you will have pride in working for
• Provides excellent training programs and opportunities for growth
• Offers Medical Benefits including:
  • Employer Contributions to HSA high deductible plan
  • Discounts at our medical facilities
  • Cigna Open Access OAPIN & OAP plans
• Supports Incentive based Wellness Programs
• Offers company sponsored Life Insurance with buy-up provisions
• Provides Dental, Vision, Long and Short Term Disability, Accident & Illness policy options
• Supports Paid Time Off and Holidays
• Gives generous 401K plan with annual 3% Employer contribution after one year of employment
• Values and appreciates its employees
• Boasts a reputation for superior health care and quality service

Essential Functions of the Position:

 Compliance

• Chairs the Compliance Committee and maintains documentation of all meetings, including agenda and minutes.
• Provides advice and direction to the Compliance Committee, FMC practitioners, ACO members, Key Management and employees to maximize compliance with statutory, regulatory and case law requirements.
• Has a strong knowledge of Stark and Self-Referral regulations.
• Maintains a strong current working knowledge of various laws, regulations, and industry guidance that affect the corporate-wide compliance program, including federal and state fraud and abuse and anti-kickback statutes, OIG guidelines and other state and federal guidelines.
• Periodically reviews and revises the compliance program in light of changes in the law, government policy changes, fraud and abuse alerts and other developments and/or needs of the clinic.
• Assists the Committee in the development and implementation of clinic-wide policies to help ensure the Clinic’s compliance with all state and federal laws and regulations.
• Oversees the development of guidelines and procedures for compliance monitoring and auditing.
• Participates in internal and external audits, including audits by federal, state and private payors; resolves compliance issues and responds to legal or administrative inquiries related to compliance issues or audits.
• Facilitates education for all employees and practitioners about compliance issues. With the Compliance Committee, develops, coordinates and participates in training programs for practitioners, management and staff, as necessary. 
• Develops, implements and maintains a well-publicized process through which personnel can raise questions and receive appropriate guidance concerning compliance. With the Compliance Committee, responds to employee’s questions and concerns.
• With the Compliance Committee, investigates any compliance problem, and where necessary takes remedial, corrective and/or disciplinary action to resolve the issue.
• Manages the coding education team.

HIPAA Privacy

• Provides HIPAA Privacy & Security training for all physicians and employees at the time of hire/orientation.
• Obtains Business Associate Agreements for all reported contractors who access Protected Health Information (PHI), and tracks same.
• Serves as the internal subject matter expert on HIPAA, maintaining current knowledge of HIPAA laws and regulations, and any other applicable federal and state privacy laws or regulations, and Reports on changes in applicable laws and regulations and provides training as needed.
• Serves as the corporate resource for release of information issues, including subpoenas.
• Manages and tracks the destruction of records.
• Assists with all requests for amendment of records.
• Receives and resolves all Privacy/Security complaints, including patient complaints and Department of Health and Human Services/Office of Civil Rights investigations.
• Performs Breach Reporting, as required.

 Additional Responsibilities:

• Performs other incidental and related duties as required and assigned.

Job Qualifications:

• Bachelor’s Degree required, advanced degree preferred (MHA, MBA, JD, etc.).
• 5+ years’ compliance experience in the healthcare industry, including experience with CMS, OIJ, DOJ, Fraud and abuse matters, the Stark Law and State and Federal anti-kickback statutes and other state and federal healthcare laws and regulations.
• In-depth understanding of HIPAA regulations, requirements and guidelines, including the Office of Inspector General (OIG) preferred.
• In-depth understanding and experience in using clinical quality improvement models and methods; NCQA PCMH Expert Certification or other QI certification preferred.
• CHC required and CCEP preferred. 
• Strong interpersonal skills, familiarity with quality improvement programs and health information technology including Meaningful Use.
• Ability to explain and present complex information clearly and thoroughly.
• Excellent relationship management skills.
• Demonstrated strong writing skills; excellent oral communication and presentation skills.
• Excellent program management skills with demonstrated experience in managing a wide range of clinical and/or administrative programs with excellent organizational and problem solving skills.
• Strong customer service orientation.

Physical and Mental Demands:

• Routine desk and office activities.
• Ability to move frequently throughout the facility and to sit for long periods of time.
• High concentration and high complexity of decision making.
• High level verbal and written communication skills.
• Above average ability to manage multiple tasks and projects simultaneously.

Occupational Exposure:

• Low risk exposure to blood borne pathogens and chemical hazards.

We are an Equal Opportunity Employer and make employment decisions without regard to race, gender, disability or protected veteran status