Compliance and Risk Manager

Position Title:            Compliance and Risk Manager

Status:                        Full-time, Exempt

Department:              Operations

Position Reports to:  Operations Director

Position Summary:  Under the supervision of the Operations Director, the Compliance and Risk Manager will work collaboratively with internal stakeholders and external regulatory agencies to ensure compliance and mitigate risk across the company with the goal to protect the health and safety of our employees. Risk and compliance monitoring responsibilities of federal, state, county and other regulatory expectations include, but are not limited to: clinic licensing and certification, HIPAA, CMS, OSHPD, Health Resources Service Administration (HRSA) and the Bureau of Primary Health Care (BPHC), Central California Alliance for Health (CCAH) and other health plans, CDC, Vaccines for Children (VFC), and Merced County Health Department. This role is the primary point of contact and authority regarding compliance with federal, state, and local agencies regarding environmental health, fire safety, occupational safety and loss control, and insurance.

Essential Duties

• Ensure the clinic is in compliance with HRSA, OSHA, OIG, FTCA, HIPAA, California agencies, Los Angeles County agencies and any other regulatory agencies.
• Develop and maintain a comprehensive compliance calendar: publish monthly and notify pertinent Directors and/or Managers of upcoming dates of trainings, inspections, audits and reports due.
• Oversee that all subpoena requests are handled in a timely matter
• Review, track, and file all variances, grievances, and potentially litigious legal cases, including the opening of precautionary files.
• Claims management, including contact and communication with malpractice claims
• Keep abreast of changing rules and regulations that will affect day-to-day and future operations of the clinic; ie. HIPAA Rules etc.
• Ensure all policies and procedures are reviewed and approved on an annual basis
• Ensure all insurance policies remain current for the clinic
• Keep inventory of all licenses, permits and certificates and ensure renewal prior to expiration date
• Ensure appropriate licenses, permits and certificates are posted in visible locations as required by law
• Perform routine auditing on various departments throughout the clinic
• Analyze the Company’s exposures risk and proactively develop best practices to avoid or minimize losses to human, financial and physical assets.
• Measure options to retain or self-insure risks against the benefit and cost of transferring risks though insurance products.
  

• Coordinate the purchase of insurance, including educators and trustees legal liability, general liability, auto liability, international liability, property coverage, as well as other recommended or required policies to protect the Company.
• Provide support, education and training to agents/executives and staff to build compliance and risk awareness within the Company.
• Develop compliance and risk management guidelines and policies to report incidents or circumstances which may give rise to a claim, and communicate to senior management accordingly.
• Collaborate with legal counsel and HR to investigate and manage claims, conduct training, and ensure compliance.
• Review all grants, contracts, and programs for deliverables, deadlines, and leads, and facilitate at least six annual meetings to communicate these goals, identify the internal lead, and ensure compliance with deliverables.
• Assist in reviewing vendor contracts to ensure that insurance requirements are consistent and proper transfer of risk mechanisms are stated, such as indemnification and hold harmless provisions.
• Verifying that vendors are compliant with insurance obligations by obtaining insurance certificates on an annual basis.
• Participating in risk management and insurance classes, seminars and conferences to further understanding of current trends facing all lines of the Company’s business.
• Working directly with facility management to assess, define, and respond to operational and compliance issues
• Providing guidance with regard to post-acute rules and regulations, especially related to Medicare and Medicaid laws
• Providing evaluation of clinical operations for facilities and make recommendations in order to provide optimal quality of care.
• Collaboratively working with the team to adapt to multiple demands and shifting priorities

Qualifications

• At least 2 years of experience with an FQHC
• Demonstrated understanding of HRSA, OSHA, OIG, FTCA, HIPAA, and other regulatory requirements
• Strong demonstrated ability to establish collaborative working relationships at all levels and build consensus.
• Excellent analytical and communication skills
• Bachelor’s Degree from an accredited university
• Strong interpersonal communication skills to effectively and diplomatically interact with physicians, staff, administration & sponsors.
• Ability to attend off-site staff meetings, conferences and investigator meetings