Compliance & Privacy Officer

April Shubert

Forum Ride Along
Job Summary:

The Compliance & Privacy Officer leads the Compliance Program of Century Ambulance Service, Inc. (“Century” or ‘the Company”), responsible for coordinating compliance activities and reporting throughout the organization. This position ensures that the Board of Directors, management and employees 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 Code of Conduct and standards for ethical behavior.

The Compliance & Privacy Officer must ensure that regular compliance activities occur to address the eight elements of Healthcare Compliance Programs, including annual risk assessment, development of a company-wide compliance work plan, auditing and monitoring activities, general and specific compliance education, development and regular review of compliance related policies and procedures, creating and maintaining open lines of communication, investigating allegations of possible misconduct, ensuring appropriate disciplinary actions are taken when compliance violations occur, and other organization-wide activities.

The Compliance & Privacy Officer serves as the leader and project manager for the Company’s Corporate Integrity Agreement reporting and related activities. This requires a high degree of personal organization and sophisticated project management skills.

As the leader of the Company’s Compliance Program, the Compliance & Privacy Officer must personally set the tone for an ethical and compliant organization. The Compliance & Privacy Officer must understand and embody the Company’s Code of Conduct, and actively uphold standards of ethical business behavior.

The Compliance Officer reports directly to and is supervised and managed by the Chief Executive Officer/President of the Company. The Compliance Officer also reports to the Chief Compliance Officer (CCO) of Covalent Health (parent company), and receives support and resources from the CCO. The Compliance & Privacy Officer provides guidance to the senior leaders of the company in matters related to the Compliance Program.

The Compliance & Privacy Officer, together with the company’s Compliance Committee, is authorized to implement all necessary actions to ensure achievement of the objectives of an effective compliance program.

Essential Duties and Responsibilities:

· Develops, maintains, and revises policies and procedures for the general operation of the Compliance Program and its related activities to prevent illegal, unethical, or improper conduct. Manages day-to-day operation of the Program.

· Develops and periodically reviews and updates the Code of Conduct to ensure continuing currency and relevance in providing guidance to management and employees.

· Collaborates with other departments (e.g., Billing, Risk Management, Internal Audit, Training, HR, etc.) to direct compliance issues to appropriate existing channels for investigation and resolution. Consults with Director-approved, designated compliance counsel as needed to resolve difficult legal compliance issues.

· Responds to alleged violations of rules, regulations, policies, procedures, and Code of Conduct by evaluating or recommending the initiation of investigative procedures. Develops and oversees a system for uniform handling of such violations.

· Performs independent reviews and evaluations to ensure that compliance Issues/concerns within the organization are being appropriately evaluated, investigated and resolved.

· Monitors, and as necessary, coordinates compliance activities of other departments to remain abreast of the status of all compliance activities and to identify trends.

· Identifies potential areas of compliance vulnerability and risk; develops/implements corrective action plans for resolution of problematic issues, and provides general guidance on how to avoid or deal with similar situations in the future.

· Provides reports at least quarterly to the Director of the Company regarding compliance matters. Provides reports as directed or requested, to keep the Director of the Company, the Compliance Committee, and senior management informed of the operation and progress of compliance efforts.

· Ensures proper reporting of violations or potential violations to duly authorized enforcement agencies as appropriate and/or required.

· Establishes and provides direction and management of the compliance Hotline.

· Institutes and maintains an effective compliance communication program for the organization, including promoting (a) use of a Compliance Hotline mechanism; (b) heightened awareness of Code of Conduct, and (c) understanding of new and existing compliance issues and related policies and procedures.

· Works with the Human Resources Department and others as appropriate to develop an effective compliance training program, including appropriate introductory training for new employees as well as ongoing training for all employees and managers.

· Monitors the performance of the Compliance Program and relates activities on a continuing basis to the CEO and President, taking appropriate steps to improve its effectiveness.

· Serves as a final internal resources with which concerned parties may contribute and after other formal channels and resources have been exhausted.

Basic Qualifications:

  • High school Diploma with at least 5 (five) years of direct experience working in a healthcare compliance-related position
  • Ability to analyze, comprehend and interpret legal and regulatory documents
  • Excellent communication and presentation skills
  • Superior administrative skills which include: multitasking, organizational, tracking and follow through
  • Advanced computer skills using Microsoft Word, Excel and PowerPoint
  • Familiar with regulatory and payer requirements for billing healthcare claims

Preferred Qualifications:

· Bachelor’s Degree or JD

  • CHC Certification
  • Experience in working with a Corporate Integrity Agreement desired

Physical & Mental Demands:

  • Requires frequent repetitive hand movements and prolonged sitting, standing, walking, reaching and grasping.
  • Occasional pushing, pulling or moving/lifting up to 50 pounds of heavy supplies and equipment.
  • Extensive use of keyboard computer.
  • Must be able to hear and communicate clearly to perform job duties in person and over the telephone.
  • Coordinate multiple tasks simultaneously.
  • Collect, interpret, and/or analyze complex data and information.
  • Understand and respond to a diverse population.
  • Utilize fine motor coordination, clear speech, and good visual acuity.

Work Environment:

  • Works in an office environment where temperatures are comfortable and noise level is low to moderate.