Contract and Compliance Administrator
Company: Upward Health of Rhode Island PC
Posted on: September 23, 2022
At Upward Health, our words speak loudly but our actions speak
louder. Our mission is to bring healthcare home to our patients. We
serve a high-needs population of people who require extra help with
their healthcare - and we bring it to them, wherever they are. We
are growing fast and are looking for an experienced, energetic,
dedicated and self-starting Contract and Compliance Administrator
in our New York Long Island office. The ideal candidate is expected
to provide professional direction, oversight and advice to UH's
Compliance and Quality Improvement Programs, which incorporate all
clinical and administrative departments. Serve as the designated
Contract and Compliance Administrator for UH and is responsible for
implementation of the Compliance Program. Responsibilities:
- Adhere to regulatory reporting guidelines and filing deadlines
through coordination across the organization and ensuring the
organization has a clearly defined program for complying with laws
- Coordinate, review and update existing policies and procedures
to adhere to any regulatory requirements for our clients,
regulators, vendors, and employees
- Create a system for managing, tracking and reporting status on
all client, provider, partner, vendor and government agreements.
This would include key milestone and renewal dates.
- Review all deliverables (not just contracts) to CMS or other
government agencies for compliance, accuracy and timeliness.
- Ensure alignment with clinical operations on cross-departmental
project management in collaboration with the technical teams for
any company-wide certification and re-certification
- Lead the alignment of cross-departmental project management of
certifications and/or any other regulatory certification needed in
current state and in the future
- Review client contracts for alignment with all components of
current and future business
- Investigates potential incidents pertaining to healthcare
coding, billing and reimbursement, any allegations of fraud, abuse
or conflict of Interest, suspected or actual breaches of privacy,
confidentiality, and security.
- Develops, performs, supervises and arranges appropriate
training and education of all staff, clinicians, and Board members
on compliance requirements.
- Act on non-compliance or at-risk situations, creating realistic
plans to overcome them
- Lead compliance meetings, organize and own meeting content,
- Prepare periodic compliance program reports for BOD input and
feedback, execute the Annual Training to the BOD and initiate
annual attestations for training completion.
- Oversee of compliance ticket system for questions and issues
received including escalation of issues as needed
- Communicates or participates in the development of
communications with regulatory agencies regarding investigations
and the resolution of any alleged violations.
- Document, collect, and prepare documentation for audits by
internal teams, CMS, or other governing bodies
- Bachelor's Degree required, Master's in healthcare
administration preferred. Candidates with a JD and significant
compliance experience are welcome to apply.
- Certification in Health Care Compliance (CHC) preferred.
- Proficiency in the use of Microsoft products and EHR systems,
- Comprehensive subject matter expertise in health care
compliance and quality improvement
- Excellent planning, analytic, and problem-solving skills
- Excellent communication (verbal, written, and presentation)
skills to convey information to diverse audiences
- Compliance experience with CMS or similar government agencies
- Experience in training and developing education programs
- Minimum 5-7+ years in a health care compliance or regulatory
role, preferably experience in managing government programs
- Effective team leadership and team participation skills board
and the public; possesses a consistent and disciplined demeanor and
ability to act as a professional role model internally and
- Tact and discretion in the conduct of investigations
- Demonstrated knowledge of federal and state laws & regulations
and accreditation requirements
- Skilled in quality improvement, systems change, and policy
development Upward Health is proud to be an equal opportunity
employer. We are committed to attracting, retaining and maximizing
the performance of a diverse and inclusive workforce. This job
description is a general outline of duties performed and is not to
be misconstrued as encompassing all duties performed within the
position. All individuals selected for a position will undergo a
background check appropriate for the position's responsibilities.
**We require all our employees to be vaccinated and to show proof
of vaccination upon hire** PM22PI191512203
Keywords: Upward Health of Rhode Island PC, Stamford , Contract and Compliance Administrator, Other , Hauppauge, Connecticut
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