Job Description

Be a part of the mission at Whitney Young Health (WYH) to provide high quality healthcare that is affordable and accessible to our diverse community.

WYH has a robust benefits package including generous time off, affordable health, dental and vision insurance, 401k with safe harbor employer match, tuition reimbursement, term life insurance, commuter benefits and more!

GENERAL RESPONSIBILITIES:

The Risk and Compliance Officer oversees the Risk Management and Corporate Compliance program for both Whitney Young Health and Equinox, functioning as an independent and objective body that reviews and evaluates compliance issues/concerns within the organization. The position ensures the Board of Directors, management, and employees in both organizations are in compliance with the rules and regulations of regulatory agencies, that company policies and procedures are being followed, and that behavior in the organization meets the company’s Standards of Conduct. Additionally the position leads and coordinates both organization’s efforts to minimize risk and any potential liability that may threaten the success of the organization. This position is the enterprise’s Compliance Officer and Privacy Officer.

SPECIFIC RESPONSIBILITIES:

Administration

• Remains current on the healthcare market and working closely with other management team members, is able to provide proactive analysis of organizational areas that may have a positive or negative impact on the enterprise’s operations.
• Responsible to stay current on best practices regarding the enterprise’s management, current and future healthcare needs and trends.
• Reviews current policies and procedures and proposes changes to Executive Leadership as appropriate.
• Implements and sustains an education process that assures a common knowledge base for providers and staff on regulatory mandates, Risk Management, HIPAA, Corporate Compliance and other relevant areas throughout the organization.
• Coordinates the process of terminating patients eligible to receive care across the enterprise.
• Reviews and maintains organization-wide contracts and agreements with third party vendors, affiliates, and community-based organizations.
• Plans and coordinates Environment of Care (EOC) rounds across all locations.

Risk Management

• Oversees organization wide Risk Management program, to include electronic database and incident reporting.
• Provides a planned organization wide process for reporting and managing claims and lawsuits in compliance with the FTCA. Completes the required annual Redeeming application for FTCA coverage.
• Serves as the lead WYH representative to the FTCA coverage and application process.
• Responsible for receiving, reviewing, trending and analyzing incident reports and taking appropriate action.
• Present substance of incidents to Governance and Corporate Compliance Committee (GCCC), Facilities Management and Emergency Operations Committee, Infection Control Committee, Pharmacy and Therapeutic Committee, Quality Improvement Committee, any other pertinent internal committees and external regulatory agencies as appropriate.
• Responsible to conduct investigations and root cause analyses as appropriate.
• Assist clinical leadership in peer review activities.
• Develops risk policies and procedures as necessary/required.
• Ensures corrective actions are implemented by appropriate managers and appropriate reports are provided to regulatory agencies as necessary.
• Leads the patient grievance process for follow up and investigations and works within the executive management team to make improvements.

Corporate Compliance

• Assists the enterprise in ensuring compliance with all State and Federal regulations, to include routine OMIG, OIG and SAMS exclusion monitoring and annual certifications of a compliance program
• Participates in network-wide preparation for regulatory surveys, audits, and site visits, including HRSA, DOH, OMH, OASAS, OCFS, OTDA, and others, in order to ensure successful reviews.
• Works closely with the CEO to ensure departments are complying with various rules and regulations ensuring equal disciplinary treatment.
• Ensures knowledge of corporate compliance programs, policies and legal opinions are current and uses knowledge to implement changes to existing program, as appropriate.
• Develops corporate compliance policies and procedures as necessary/requested.
• Collects and investigates all potential corporate compliance submissions from programs, and enforces the non-intimidation/non-retaliation policy.
• Integrally involved in the auditing of billing practices, both within clinical operations and grant-funded actions.
• Prepares and reports compliance issues to the CEO, Boards of Directors, and Board Committees and to the regulatory authorities as required.
• Accessible to all staff and the public and retains anonymity as appropriate.
• Leads incident review committee for Justice Center related programs.
• Conducts/designates corporate compliance audits.
• · Creates and executes training for boundaries in healthcare and ethics expectations of all staff.

Miscellaneous

• Works with our Credentialing Vendor for new appointments as well as reappointments.
• Works with the CEO and clinical leadership on provider privileging.
• Serves as the organization administrator for NYS Health Commerce System (HCS) and the New York State Immunization Information System (NYSIIS).
• Reviews all Certificates of Need (CON) submitted to NYS DOH, NYS OMH, and/or NYS OASAS.
• Develops and manages compliance and risk management content for WYH’s Learning Management System (LMS) to keep staff educated and competent in these areas.
• Demonstrates excellence in both internal and external customer service.
• Understands and is able to effectively communicate HIPAA compliance, corporate compliance and client confidentiality.
• Ensures and/or remains in compliance with local, state, and federal regulation, especially relating to HRSA, DOH, OMH, OASAS, OCFS, and OTDA.
• Adheres to the National Patient Safety Goals as defined by the Joint Commission and Whitney M. Young Jr. Health Center.
• Completes other duties as assigned.

Requirements

MINIMUM QUALIFICATIONS:

Bachelor’s Degree in Health or Human Services, minimum of 10 years’ experience in a healthcare setting to include leadership experience. Demonstrated knowledge of operational, financial, quality improvement, risk management and human resource procedures and regulations.

PREFERRED QUALIFICATIONS:

Master’s Degree in a health care/management discipline, Certification in Healthcare Compliance (CHC).

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other legally protected status.

Salary Range: $120,000 - $130,000 annually