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Director Compliance Operations and Privacy

Job ID 84368 Date posted 11/14/2017
  • Facility: Sharp HealthCare
  • City: San Diego
  • Department: SHC SCMG Admin
  • Category: Executive Jobs
  • Job Status: Full-Time
  • Shift: Day Job
  • FTE: 1.0
  • Shift Start: Variable
  • Shift End Time: Variable
Director of SCMG Compliance Operations and Privacy
 
Sharp Community Medical Group
Caring for more than 350,000 patients each year
 
Sharp Community Medical Group, Inc. (SCMG) is a private practice-based Medical Group that was formed on September 8, 1989. The group consists of approximately 230 primary care physicians and 570 specialists in private practices throughout San Diego. Hospital affiliations include Sharp Memorial Hospital, Sharp Mary Birch, Sharp Chula Vista Medical Center, Sharp Grossmont Hospital, Sharp Coronado Hospital and Palomar Pomerado Health Care System.
 
SCMG's physicians have access to 10 managed care health plans. SCMG offers patients comprehensive health care through an extensive physician, ancillary and hospital referral base.  SCMG is recognized for its commitment to delivering quality care through private practice physicians in the most efficient and effective manner.
 
Summary:
The SCMG Director of Compliance Operations and Privacy (“Director”) reports to the CEO of Sharp Community Medical Group. The Director is responsible for development, implementation, operations, tracking and documentation of the SCMG and SharpCare Corporate Compliance & Privacy Programs.  The Director is responsible for documenting the activities and effectiveness of the compliance and privacy program in order to help mitigate potential civil penalties or other sanctions in case of a government investigation and action. 
 
The Director is responsible for assisting, coordinating and implementing the core elements of SCMG and SharpCare’s Compliance Program specific to the elements of an effective compliance program this entails, compliance committees, annual compliance audit plan development, hotline investigations, training, education and policies and procedures.  As such, the Director manages various projects and functions of the SCMG and SharpCare Compliance Department with primary oversight of all ongoing activities in the development, implementation, maintenance, of and adherence to SCMG’s and Sharp HealthCare’s policies and procedures covering the privacy of, and access to, patient health information in compliance with federal and state laws and Sharp HealthCare’s information privacy practices.
 
The Director will plan and direct schedules as well as project budgets, monitor the program/projects from initiation through delivery, interfacing with all applicable stakeholders on all matters, with sensitivity to the often confidential nature of the work.  The Director will develop detailed work plans, schedules, project estimates, resource plans, budgets, and status reports, conduct project meetings and will be responsible for project deliverables.
 

The Director is responsible for planning and leading critical and highly visible projects and managing/monitoring assigned internal and external resources, as assigned.  Written reports issued to document compliance investigations, key observations and findings, and corrective action plans resulting from the Director’s work are shared with the SCMG and Sharp Corporate Compliance Committees. 

 

Required Skills and Qualifications:
  • Ten (10) + years working in the healthcare industry, in health information management (HIM), legal or compliance role.
  • Knowledge of regulatory frameworks and operational impact of applicable federal and California laws and regulations. 
  • Understanding of health information/record processes, information technology and information security practices. 
  • Ability to clearly communicate with a broad spectrum of individuals and groups, including executive management and the Board of Directors
  • Demonstrated organization, facilitation, communication and presentation skills.
  • Ability to develop and administer policies and procedures relating to system-wide health information privacy management.
  • Ability to design and implement training programs to educate all staff levels, management and physicians about health information privacy procedures
  • Must possess strong analytical and problem solving skills. 
  • Expertise in the use of desktop computer tools including the internet, Outlook, Word, and Excel.
     

Education: 

  • Bachelor's degree is required.
  • MBA, MHA, M.S. or J.D or related degree is preferred.
 
Certification:
  • Certification in Healthcare Compliance and or Privacy preferred.
 
Skills, Knowledge and Abilities:
  • Must have a comprehensive understanding of California and Federal laws pertaining to healthcare operations, third party payor regulations (public, private, and governmental) and accreditation standards (i.e., JCAHO, CAP). 
  • Must possess knowledge of coding and reimbursement rules and regulations, and medical and diagnostic terminology.
  • Capacity to communicate technical information in a clear and effective manner to a wide spectrum of professionals and clinical staff.
  • Experience in developing educational materials and conducting presentations. 
  • Ability to write and implement policies and procedures.  
 
Customers Served:

SCMG and SharpCare physicians, office staff and patients, SCMG Executive Management, SHC Corporate Compliance Department, Vendors, Business Associates 

 

Compensation and Benefits:
The position provides a very competitive compensation, including opportunity to participate in an entity incentive program along with a generous benefit package.

Key Responsibilities:

The Director of Corporate Compliance Operations and Privacy is accountable for:
  • Coordinating ongoing development, efficiency and organization of the SCMG and SharpCare strategic initiatives around compliance and privacy.
  • Providing direct support to the CEO SCMG and VP Physician Network Development in an effort to enhance the corporate compliance operations, focusing on imperatives, projects and processes that are designed to provide the maximum quality, security and integrity for SCMG and SharpCare patients, physicians, leadership, staff, vendors and affiliated entities.
  • Writing the SCMG and SharpCare Compliance Audit Plan and Risk Assessments.
  • Reviewing and periodically updating the SCMG and SharpCare Code of Conduct and recommends a process for effective dissemination and communication of the Code of Conduct to all SCMG and SharpCare physician offices and staff.
  • Managing all aspects of SCMG and SharpCare’s Compliance Program.  Whereby principal duties include the establishment and oversight of key activities related to the SCMG and SharpCare Compliance Program operations in accordance with the relevant guidance from the Office of Inspector General.
  • Managing all aspects of the Privacy Program activities covering the privacy of, and access to, patient health information in compliance with federal and state laws and assisting SCMG and SharpCare physician offices in information privacy practices.
  • Providing oversight and/or participation on key compliance-related committees and advises on development and communication of policies and procedures pertaining to all parts of the compliance program.
  • Coordinating and monitoring/responding to hotline calls and investigations while collaborating with Legal Services and Human Resources.
  • Tracking progress and facilitating successful completion of the annual SCMG and SharpCare Compliance Program Audit Plan approved by the SCMG and SharpCare Compliance Committees.
  • Developing, maintaining and updating compliance and privacy training curriculum and resource materials for SCMG and SharpCare physician office employees and physicians.
  • Conducting training sessions for SCMG and SharpCare physician office staff, physicians and other business affiliates of SCMG and SharpCare as needed.
  • Working closely with the Sharp Corporate Compliance Department on continuing compliance and privacy education and implementing ongoing risk assessments and monitoring techniques.
  • Meeting with management, as appropriate, to communicate audit/investigation results, develop corrective action plans, and provide additional education and training as required.
  • Leading the planning and execution of the SCMG and SharpCare Compliance Committees.
  • Applying project management discipline to all other significant ethics and compliance initiatives and special projects including tracking and monitoring the status of initiatives, developing status reports, managing the department calendar, organizing ethics and compliance records, documents and files and maintaining document databases.
Physical Requirements:
  • Ability to sit for long periods of time at desk.
  • Telephone and usage skills.
  • Computer knowledge and skills.
  • Drives frequently to Sharp HealthCare affiliated entities’ facilities and other organizations.
  • Lifts, files and/or equipment or twenty (20) pounds or less.
Additional Physical Requirements may be discussed during the interview
“Sharp HealthCare is proud to be an Equal Opportunity/Affirmative Action Employer.  All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, gender identity, transgender status, sexual orientation, protected veteran status or any other protected class.”
Keywords: Director Compliance Operations and Privacy, SCMG, Medical Group, HIM jobs, Sharp Healthcare jobs, Healthcare compliance jobs, Privacy jobs, Healthcare jobs, Executive jobs, Healthcare Executive, San Diego jobs, HCCA, AMGA jobs, Sharp Community Medical Group jobs, Executive medical group jobs

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