Network Healthcare Compliance Auditor

St. Luke's University Health Network
Published
October 16, 2020
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Description

St. Luke's is proud of the skills, experience and compassion of its employees. The employees of St. Luke's are our most valuable asset! Individually and together, our employees are dedicated to satisfying the mission of our organization which is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses and other health care providers; and improve access to care in the communities we serve, regardless of a patient's ability to pay for health care.

The Network Healthcare Compliance Auditor audits, investigates and educates about compliance related matters that include billing and documentation requirements, physician and vendor relationships and regulatory compliance policies and regulations. Directly contributes to 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 St. Luke’s University Health Network.

JOB DUTIES AND RESPONSIBILITIES:

  • Initiate and complete the research, investigation, auditing, review and analysis of general compliance, billing, HIPAA Privacy, and other matters to ensure compliance with governmental regulations and internal policies. 
  • Research, audit and/or analyze complex data, evaluate the information, draw logical conclusions, demonstrate financial acumen and create proposed solutions to root cause issues.
  • Act as a strategic thinker within the Network Compliance Department and lead and/or contribute to department initiatives, such as assisting with the annual risk assessment, identifying areas for audit opportunities, monitoring and adapting to regulatory changes, expanding upon the compliance work plan and leading the quarterly newsletter.
  • Develop, coordinate and create technical and creative content to support a multifaceted educational and training program that focuses on the elements of the Compliance Program, as well as work to ensure that all appropriate business partners, employees and management are knowledgeable of, and comply with, pertinent federal and state standards.
  • Conduct investigations of alleged compliance incidents, develop corrective action plans for the resolution of problematic issues and track, monitor and report on all investigation outcomes.
  • In coordination with the Manager, Network Compliance, work to enforce compliance standards through disciplinary processes and ensure that disciplinary actions for compliance matters are consistent across St. Luke’s.
  • Maintain and contribute to 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 St. Luke’s Code of Conduct, and (d) understanding of new and existing compliance matters and related policies and procedures.
  • Serve as a member of the compliance committee, create topical content, agendas and other meeting materials (e.g., handouts, graphs, minutes, etc.) and lead/participate in compliance subcommittee meetings.
  • Initiate, develop, maintain, and revise policies, procedures and practices for the general compliance and operations of St. Luke’s and its related activities to prevent illegal, unethical, or improper conduct.

PHYSICAL AND SENSORY REQUIREMENTS:

Must possess hearing, seeing, speaking and reasoning senses necessary to carry out job duties. Must be able to sit for long periods throughout the day, with intermittent periods of standing, walking, bending, twisting and reaching necessary to carry out duties of job. Sedentary work, with occasional lifting/carrying of objects such as office supplies, files, etc. with maximum weight of ten pounds. Must be able to pay close attention to details, concentrate on work and observe work of others. Must have the ability to travel throughout the Network as needed; travel obligation is minimal.

EDUCATION

Minimum of Bachelor’s degree from an accredited college or university, preferably in a healthcare, business or finance related field, is required.

TRAINING AND EXPERIENCE

Minimum of five (5) years of compliance, auditing, healthcare and/or hospital operations experience, preferably within a complex healthcare system. Experience with compliance programs, regulatory research, auditing, and/or policy and procedure development is required. The following experience is highly desirable: Clinical, financial and/or coding medical record audit experience; or Nursing experience in an acute care hospital, case management, utilization management, or clinical auditor, focused on compliance related activities; or Internal audit or accounting experience. Certified in Healthcare Compliance (CHC) desired at time of or within 18 months of hire.  CPC, CCS are also desired.

Please complete your application using your full legal name and current home address.  Be sure to include employment history for the past seven (7) years, including your present employer.  Additionally, you are encouraged to upload a current resume, including all work history, education, and/or certifications and licenses, if applicable.  It is highly recommended that you create a profile at the conclusion of submitting your first application.  Thank you for your interest in St. Luke's!!

St. Luke's University Health Network is an Equal Opportunity Employer.

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