Compliance Partner I

Compliance Partner

BJC Health has an opportunity for a Compliance Partner. In this role, you will be responsible for managing unethical behavior complaints to include compliance complaints and privacy concerns. Your duties will involve responding to and investigating these issues, collaborating with functional and operational teams, and providing advice and counsel as necessary. The position requires independent work and critical thinking to determine the appropriate course of action. You will be tasked with deciphering the validity of complaints, which may involve interactions with patients, internal employees, or other regulatory agencies.

BJC HealthCare is one of the largest nonprofit health care organizations in the United States, delivering services to residents primarily in the greater St. Louis, southern Illinois and southeast Missouri regions. With net revenues of $6.3 billion and more than 30,000 employees, BJC serves patients and their families in urban, suburban and rural communities through its 14 hospitals and multiple community health locations. Services include inpatient and outpatient care, primary care, community health and wellness, workplace health, home health, community mental health, rehabilitation, long-term care and hospice. BJC is the largest provider of charity care, unreimbursed care and community benefits in the state of Missouri. BJC and its hospitals and health service organizations provide $785.9 million annually in community benefit. That includes $410.6 million in charity care and other financial assistance to patients to ensure medical care regardless of their ability to pay. In addition, BJC provides additional community benefits through commitments to research, emergency preparedness, regional health care safety net services, health literacy, community outreach and community health programs and regional economic development. BJC's patients have access to the latest advances in medical science and technology through a formal affiliation between Barnes-Jewish Hospital and St. Louis Children's Hospital with the renowned Washington University School Of Medicine, which consistently ranks among the top medical schools in the country.

Role Purpose

The Compliance Partner supports the yearly Corporate Compliance Workplan and serves as a resource to BJC's HSO and operational teams under review or investigation by government auditors including but not limited to Medicare Audit Contractors, Supplemental Review Medical Contractors, Office for Civil Rights, and the Office of Inspector General.

Responsibilities

• Responsible for monitoring and auditing activities of the specific program assigned (including clinical, billing, patient privacy, IRB, and information management) to ensure compliance with institutional policies, industry standards, and applicable regulations.
• Responsible for developing, coordinating, and performing all components of assigned compliance or privacy audit reviews and investigations for the organization and all HSOs.
• Coordinating and scheduling audits, assessing the environment and developing the appropriate audit methodology, facilitating sessions with operational owners, documenting processes using flowcharts, narratives, and other appropriate tools and the respective internal controls.
• Performing detailed audit and investigation procedures, assessing results, and communicating audit findings to management at all levels and assisting management in developing appropriate action plans and monitoring procedures / tools.

Minimum Requirements

Preferred Requirements

BJC Total Rewards At BJC we're committed to providing you and your family with benefits and resources to help you manage your physical, emotional, social and financial well-being.

The above information on this description has been designed to indicate the general nature and level of work performed by employees in this position. It is not designed to contain or be interpreted as an exhaustive list of all responsibilities, duties and qualifications required of employees assigned to this job. Equal Opportunity Employer