Regulatory Compliance Manager - Hybrid / Remote

Compliance Officer

Ensures patient billing practices conform to government reimbursement guidelines by monitoring current practices, managing and documenting audit processes, developing and implementing systems to track compliance activities and providing compliance education.

Essential Functions :

• Supports Compliance Administrator in policy review and creation.
• Monitors and assists in drafting required documentation related to compliance processes.
• Works to identify trends, issues, and risk areas while giving details and improvement recommendations.
• Participates in creation, monitoring, and updates of educational and training programs to enhance compliance and awareness of compliance issues.
• Maintains current knowledge regarding federal and state guidance, organizational needs, and regulations. Serves as an expert resource in issue resolution.
• Collaborates with faculty and staff to assist departments to implement compliance practices. Coordinates with departments to monitor compliance activities.
• Conducts audits / investigations to ensure compliance with University, state and federal guidelines. Problem Solving Incumbent is responsible for assisting the University in preparation for regulatory audits by developing, monitoring and updating quality controls and recommending actions to maintain compliance. This position is the primary contact and expert regarding regulatory agency standards governing healthcare program requirements. Representative challenges of this position include determining the validity of collected data, assessing process shortfalls, and developing effective safeguards to reduce risk. The incumbent must possess the ability to foster collaborative working relationships with a wide range of constituencies.

Work Environment and Level of Frequency typically required : Nearly Continuously : Office environment.

Physical Requirements and Level of Frequency that may be required : Nearly Continuously : Sitting, hearing, listening, talking. Often : Repetitive hand motion (such as typing), walking. Seldom : Bending, reaching overhead.

Minimum Qualifications : Bachelor's degree in Health Care Administration, Business Administration or a related field or equivalency (one year of education can be substituted for two years of related work experience). Five years regulatory or administrative law experience, with at least three of those years in a health care setting or equivalency; coding certification (CPC, ACS, CCS-P / H, RHIA); knowledge of medical auditing, Federal healthcare program policies and requirements (including Medicare Parts A and B), and ICD-10, CPT, HCPCS, DRG coding; proficient with word processing, spreadsheet and related computer applications; demonstrated human relations and effective communication skills also required. Knowledge of utilization review and quality assurance procedures is preferred. An understanding of University operations, policies and technology is preferred. Training or teaching experience is also preferred. Applicants must demonstrate the potential ability to perform the essential functions of the job as outlined in the position description.

Preferences : Same as minimum qualifications.

Special Instructions Summary : Writing and competency test will be requested.

Additional Information : The University is a participating employer with Utah Retirement Systems ("URS"). Eligible new hires with prior URS service, may elect to enroll in URS if they make the election before they become eligible for retirement (usually the first day of work). Contact Human Resources at (801) 581-7447 for information. Individuals who previously retired and are receiving monthly retirement benefits from URS are subject to URS' post-retirement rules and restrictions. Please contact Utah Retirement Systems at (801) 366-7770 or (800) 695-4877 or University Human Resource Management at (801) 581-7447 if you have questions regarding the post-retirement rules. This position may require the successful completion of a criminal background check and / or drug screen. The University of Utah values candidates who have experience working in settings with students and patients from all backgrounds and possess a strong commitment to improving access to higher education and quality healthcare for historically underrepresented students and patients. All qualified individuals are strongly encouraged to apply. Veterans' preference is extended to qualified applicants, upon request and consistent with University policy and Utah state law. Upon request, reasonable accommodations in the application process will be provided to individuals with disabilities. The University of Utah is an Affirmative Action / Equal Opportunity employer and does not discriminate based upon race, ethnicity, color, religion, national origin, age, disability, sex, sexual orientation, gender, gender identity, gender expression, pregnancy, pregnancy-related conditions, genetic information, or protected veteran's status. The University does not discriminate on the basis of sex in the education program or activity that it operates, as required by Title IX and 34 CFR part 106. The requirement not to discriminate in education programs or activities extends to admission and employment. Inquiries about the application of Title IX and its regulations may be referred to the Title IX Coordinator, to the Department of Education, Office for Civil Rights, or both. To request a reasonable accommodation for a disability or if you or someone you know has experienced discrimination or sexual misconduct including sexual harassment, you may contact the Director / Title IX Coordinator in the Office of Equal Opportunity and Affirmative Action (OEO / AA). More information, including the Director / Title IX Coordinator's office address, electronic mail address, and telephone number can be located at : . Online reports may be submitted at . This report includes statistics about criminal offenses, hate crimes, arrests and referrals for disciplinary action, and Violence Against Women Act offenses. They also provide information about safety and security-related services offered by the University of Utah. A paper copy can be obtained by request at the Department of Public Safety located at 1658 East 500 South.