Compliance Program Operations Specialist
In this role, you will be part of the Ethics & Compliance Department's Compliance Program Operations team, responsible for supporting Banner Health's compliance oversight obligations regarding contractors / vendors, coordinating compliance attestations and audit requests, and supporting other compliance program activities as needed. This position is hybrid (Arizona) working regular business hours.
Within Banner Health Corporate, you will have the opportunity to apply your unique experience and expertise in support of a nationally-recognized healthcare leader. We offer stimulating and rewarding careers in a wide array of disciplines. Whether your background is in Human Resources, Finance, Information Technology, Legal, Managed Care Programs or Public Relations, you'll find many options for contributing to our award-winning patient care.
Position Summary
This position conducts assigned activities as defined in the applicable annual plan or other guidance or as directed by leadership. Performs activities at the direction of leadership, including but not limited to, audit or oversight activities, preparation of reports of findings, issue research or investigation, provide education, development of corrective actions and monitoring activities, coordination and management of reviews and third-party audits.
Core Functions
1. Manages complex and sensitive questions and issues. Conducts assigned activities, including but not limited to audits, utilizing defined standards and processes and is able to identify areas of potential non-compliance. Communicates applicable compliance issues as per policy. Prepares and maintains reports, plans or other documents as directed. Assists in the development and monitoring of corrective action plans and provides training or other activities as assigned. Communicates in a professional manner with all individuals and entities.
2. Provides answers and support to internal and external customers in a timely and appropriate manner. Supports involved internal and external individuals and entities by responding to questions or concerns, researching matters of note, providing training and other assistance as necessary.
3. Assists external investigation efforts in conjunction with Compliance leadership or the Banner Legal Department. Maintains investigation integrity by managing investigation files, reviewing applicable laws and regulations, Banner internal policies and related operational processes.
4. Assists the organization's compliance leadership, as directed, to research and investigate complaints, concerns or questions relative to compliance issues. Investigates and follows up on reported issues as directed.
5. Knowledgeable on current compliance-related laws and regulations through personal initiative, seminars, training programs and peer contact to maintain competence. Reviews related policies and procedures and applicable literature.
Minimum Qualifications
Requires knowledge typically gained with completion of a bachelor's degree in compliance, healthcare or related field. Requires skills and abilities normally acquired with two years of payer, clinical or healthcare operations experience. Must be able to understand and apply complex healthcare related government statutes, regulations or sub-regulatory guidance. Requires the following : healthcare clinical or payer knowledge; written, verbal and collaborative communication skills; critical thinking skills; computer skills in word processing and spreadsheets; ability to organize workload and manage multiple projects and maintain confidentiality of all work information.
Relevant certification based on assigned area of focus after one year of hire is required. Preferred Qualifications
Experience in Payer or Healthcare operations, regulatory requirements or audit standards preferred as relevant to the position. Additional related education and / or experience preferred.
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