Baylor Scott & White Health
Manager Compliance - Billing & Third Party
Baylor Scott & White Health, Dallas, Texas, United States, 75246
JOB SUMMARY
A high number of candidates may make applications for this position, so make sure to send your CV and application through as soon as possible. Baylor Scott & White Health (BSWH) is committed to the operation of an effective compliance program. The Corporate Compliance Manager works under the direction of the Compliance Vice President and/or Director to manage ongoing activities related to the development, implementation, maintenance of and adherence to BSWH policies and procedures in compliance with federal, state and local laws and regulations
ESSENTIAL FUNCTIONS OF THE ROLE
Position Overview:
Collaborate with the BSWH Compliance Director and/or Chief Compliance Officer, acting as the technical expert on laws, regulations, and guidance related to compliance risk areas.
Key Responsibilities:
Audit Plan Design and Implementation:
Assist in designing and implementing the annual audit plan for the BSWH Compliance Program.
Manage workflow and compliance audit processes to ensure timely completion in line with regulatory requirements and the Corporate Compliance audit plan.
Provide written reports on auditing activities, including identifying and assessing risks, planning and conducting compliance reviews, compiling review documents, and reporting findings.
Develop recommendations including corrective action plans, regulatory guidance, and education.
Investigation Response:
Assist in responding to federal, state, and internal investigations.
Oversee project direction for timelines and regulatory compliance, maintain project documentation, government correspondence, and project databases.
Staff Development:
Develop and retain staff, provide performance feedback, and take corrective actions.
Act as a technical resource, provide project direction and oversight, and evaluate project status.
Complete annual staff evaluations, monitor goal progress, and offer mentoring, training, and career development opportunities aligned with BSWH Talent Management paths.
Review and update procedures, recommend policy updates, and develop new policies as needed.
Maintain current knowledge of government laws, guidance, and regulations.
Communicate regulatory changes to pertinent individuals and assist in process modifications to ensure compliance.
Third-Party and Joint Venture Compliance:
Conduct ongoing compliance activities related to third-party vendors and joint ventures.
Perform annual risk assessments and develop annual work plans addressing service-specific risks.
Develop and maintain quarterly reporting tools to evaluate compliance program outcomes and effectiveness.
Follow through with reported concerns to implement effective corrective actions.
Develop metrics and dashboard reporting for compliance outcomes related to joint ventures and third-party vendors.
Vendor Management:
Partner with the Vendor Management Office and provide compliance metrics for monthly reporting.
Maintain documentation for incident reviews, resolutions, and appropriate corrective actions.
Develop and maintain policies for third-party vendors.
Collaboration and Ethics:
Establish collaborative partnerships with key management to address business ethics and compliance issues.
Implement leading-edge principles and practices.
Performs other duties as assigned.
KEY SUCCESS FACTORS
Healthcare experience preferred.
Management experience preferred.
Excellent knowledge of corporate compliance and business ethics programs, HIPAA and other healthcare regulatory requirements, interview and investigation skills.
Mastery of computer skills including word processing, spreadsheets, and databases along with proficient writing skills, preparation of formal presentations and reports, and the ability to communicate clearly and concisely (both oral and written) are also required.
BENEFITS
Our competitive benefits package includes the following
Immediate eligibility for health and welfare benefits
401(k) savings plan with dollar-for-dollar match up to 5%
Tuition Reimbursement
PTO accrual beginning Day 1
Note: Benefits may vary based upon position type and/or level
QUALIFICATIONS
- EDUCATION - Bachelor's
- EXPERIENCE - 5 Years of Experience PDN-9c644faf-cc1c-4c22-b009-af68343eda74
A high number of candidates may make applications for this position, so make sure to send your CV and application through as soon as possible. Baylor Scott & White Health (BSWH) is committed to the operation of an effective compliance program. The Corporate Compliance Manager works under the direction of the Compliance Vice President and/or Director to manage ongoing activities related to the development, implementation, maintenance of and adherence to BSWH policies and procedures in compliance with federal, state and local laws and regulations
ESSENTIAL FUNCTIONS OF THE ROLE
Position Overview:
Collaborate with the BSWH Compliance Director and/or Chief Compliance Officer, acting as the technical expert on laws, regulations, and guidance related to compliance risk areas.
Key Responsibilities:
Audit Plan Design and Implementation:
Assist in designing and implementing the annual audit plan for the BSWH Compliance Program.
Manage workflow and compliance audit processes to ensure timely completion in line with regulatory requirements and the Corporate Compliance audit plan.
Provide written reports on auditing activities, including identifying and assessing risks, planning and conducting compliance reviews, compiling review documents, and reporting findings.
Develop recommendations including corrective action plans, regulatory guidance, and education.
Investigation Response:
Assist in responding to federal, state, and internal investigations.
Oversee project direction for timelines and regulatory compliance, maintain project documentation, government correspondence, and project databases.
Staff Development:
Develop and retain staff, provide performance feedback, and take corrective actions.
Act as a technical resource, provide project direction and oversight, and evaluate project status.
Complete annual staff evaluations, monitor goal progress, and offer mentoring, training, and career development opportunities aligned with BSWH Talent Management paths.
Review and update procedures, recommend policy updates, and develop new policies as needed.
Maintain current knowledge of government laws, guidance, and regulations.
Communicate regulatory changes to pertinent individuals and assist in process modifications to ensure compliance.
Third-Party and Joint Venture Compliance:
Conduct ongoing compliance activities related to third-party vendors and joint ventures.
Perform annual risk assessments and develop annual work plans addressing service-specific risks.
Develop and maintain quarterly reporting tools to evaluate compliance program outcomes and effectiveness.
Follow through with reported concerns to implement effective corrective actions.
Develop metrics and dashboard reporting for compliance outcomes related to joint ventures and third-party vendors.
Vendor Management:
Partner with the Vendor Management Office and provide compliance metrics for monthly reporting.
Maintain documentation for incident reviews, resolutions, and appropriate corrective actions.
Develop and maintain policies for third-party vendors.
Collaboration and Ethics:
Establish collaborative partnerships with key management to address business ethics and compliance issues.
Implement leading-edge principles and practices.
Performs other duties as assigned.
KEY SUCCESS FACTORS
Healthcare experience preferred.
Management experience preferred.
Excellent knowledge of corporate compliance and business ethics programs, HIPAA and other healthcare regulatory requirements, interview and investigation skills.
Mastery of computer skills including word processing, spreadsheets, and databases along with proficient writing skills, preparation of formal presentations and reports, and the ability to communicate clearly and concisely (both oral and written) are also required.
BENEFITS
Our competitive benefits package includes the following
Immediate eligibility for health and welfare benefits
401(k) savings plan with dollar-for-dollar match up to 5%
Tuition Reimbursement
PTO accrual beginning Day 1
Note: Benefits may vary based upon position type and/or level
QUALIFICATIONS
- EDUCATION - Bachelor's
- EXPERIENCE - 5 Years of Experience PDN-9c644faf-cc1c-4c22-b009-af68343eda74