Job Description:

Optim Health System is seeking a full time Compliance Officer for our Savannah location. This position will report directly to the CEO of Optim.

Job Requirements:

• Participates in the implementation of the Optim Health System Compliance and Ethics Program at Facilities.
• Responsible for assisting in the planning, design, implementation and monitoring of the compliance program.
• Demonstrates understanding of and promotes adherence to the Optim Health System Code of Conduct, the Optim Health System Compliance and Ethics Program and all laws, regulations, and company policies governing the delivery of quality health care services.
• Understands regulatory laws and guidelines, and partners with local management and regional leaders to provide continual risk assessment, development of comprehensive policies and procedures, compliance training, protocols, internal investigations, providing regulatory reviews & opinions and auditing and monitoring.
• Serves as a contact person for reports of concerns or potential compliance issues. Confers with management staff to identify and correct potential areas of noncompliance and anticipate future compliance requirements.
• Coordinates the development, maintenance, implementation, and revision of policies, process and procedures and other documents for the operation of the compliance program.
• Works with Legal, Operations and other functions to assure awareness of regulatory compliance requirements applicable to Facilities provision of healthcare and related services; review and make recommendations with respect to the Facilities policies and processes related to such compliance requirements (e.g., state and local law licensing requirements).
• Possesses a clear understanding of healthcare law and revenue cycle management and the ability to conduct advanced research.
• Develops and implements investigation procedures to ensure adequate and timely follow-up to all Facilities Compliance Hotline reports and all other reports of potential compliance violations received through other channels.
• Develops an audit plan to verify compliance with Facilities’ Compliance Policies and Procedures by all employees, at all worksites.
• Reviews results of excluded person monitoring for all new employees or independent contractors in conjunction with Human Resources and coordinate responses to identified person who may be a match to an excluded person at the Federal or State level.
• In consultation with Human Resources, participates in the implementation of and promotes the usage of disciplinary guidelines regarding the actions to be taken for violations of the Compliance Policy and Procedures.
• Monitor the day to day compliance activities of Facilities. Analyze statistical data and reports to identify and determine compliance issues.
• Performs compliance audits for the purpose of monitoring processes and detecting noncompliance, including coordinating audit activities and responses. Prepares audit reports and makes recommendations to CEO and local management based on findings. Prepares periodic reports for management and the Compliance Committee of Facilities.
• Reviews and updates Facilities Compliance Policies, contracts and other compliance related materials to ensure they are current and relevant with all applicable federal, state, and industry laws, regulations, and standards in providing guidance to management and employees.
• Assists in the development and provision of compliance training to employees, medical staff, and independent consultants. Compiles training reports to monitor adherence to training requirements.
• Performs research and analysis on Corporate and federal payer rules, regulations and transmittals and communicates requirements to operational areas.
• Participates in Compliance Operations Meetings and assists with the tracking and resolution of compliance issues that affect operations.
• Maintains logs of inquiries and tracks research and disposition of compliance issues raised by senior management, employees, business partners and external auditors.
• Collaborates with operational department managers to resolve compliance or regulatory concerns.
• Communicates regularly with internal departments to ensure audit deliverables and remediation responses are submitted timely.
• Acts as a resource for compliance, government and third-party reimbursement regulations and rules.
• Provides advisory assistance regarding billing compliance matters.
• Formulate, affect, interpret, and implement compliance policies and procedures as needed.

Bachelors Degree required.

Optim Offers:

• Competitive Pay
• Company Benefits
• Vacation, Personal Time Off and Sick Leave
• Holiday Pay
• 401K Plan

Behaviors

• Detail Oriented: Capable of carrying out a given task with all details necessary to get the task done well
• Team Player: Works well as a member of a group

Motivations

• Work-Life Balance: Inspired to perform well by having ample time to pursue work and interests outside of work