Conducts preliminary investigations on matters of alleged non-compliance for all corporate services of Children's Health System of Texas. This position is part of the compliance team that ensures system personnel comply with policies, procedures and regulatory requirements. The incumbent of this position will serve as the software system administrator for two primary functions in the compliance program; Conflict of Interest and Code of Conduct.
Job Specific Responsibilities
Maintains knowledge of system policies and organizational processes that support the seven (7) elements of an effective compliance program as defined by the Office of the Inspector General and at the direction of the Chief Compliance Officer and/or Sr. Director of Accreditation and Compliance.
Maintains document management of all system investigations; that will include, staff interviews, applicable policies either at the departmental level or those applicable across the system and other investigational supporting documentation.
Develops general compliance educational activities. This includes preparing educational materials for large scale educational seminars (i.e., physician/medical staff training, leadership training) and smaller, informal sessions (i.e., brown bag/staff meeting training sessions).
Serves as a key department representative with regulatory agency representatives, collecting content and providing presentation materials for review.
Works with division leaders in the implementation of Compliance policies throughout Children’s. Includes participating on workgroups, task groups, tracking milestones of implementation and development, research, or engagement of required educational needs assessment.
Interacts with outside vendors and key customers to insure all projects, required documents, and other forms of transaction based interactions are appropriately managed and met.
Maintains up-to-date knowledge of CMS, Medicare/Medicaid, and Office of the Inspector General regulations regarding existing and emerging hospital and physician billing compliance requirements and patient privacy issues that might affect Children’s; for the purpose of informing management and recommending policy/procedure updates.
Prepares initial drafts of various reports to senior management, including, but not limited to reports to the Board of Directors, SLT, Directors Council. Prepares materials/handouts for various compliance and privacy workgroups or meetings. Acts as the primary contact for Contract Administration/Management for division.
Maintains up-to-date communication efforts related the Compliance Program. This person will ensure that the Code of Conduct content and required employee attestation is maintained and reviewed annually. Additionally, this person will work with the Learning Institute and Clinical Education department in maintaining current and up to date required educational objectives and knowledge base as defined by regulatory mandates (e.g., Conflict of Interest, HIPAA Rule, etc.)
Required: Minimum of 3 years working in a hospital/healthcare environment in an administrative or clinical role, preferably in Regulatory Compliance and/or Legal.
Required: Four-year Bachelor's degree or equivalent experience
Specific Knowledge, Skills and Abilities
Maintain effectiveness when experiencing major changes in work responsibilities or environment; adjust effectively to work within new work structures, processes, requirements, or cultures.
Use appropriate interpersonal styles to establish effective relationships with customers and internal partners; interact with others in a way that promotes openness and trust and gives them confidence in one's intentions.
Develop and use collaborative relationships to facilitate the accomplishment of work goals.
Identify and understand issues, problems, and opportunities; compare data from different sources to draw conclusions; use effective approaches for choosing a course of action or developing appropriate solutions; take action that is consistent with available facts, constraints, and probable consequences.
Take prompt action to accomplish objectives; take action to achieve goals beyond what is required; be proactive.
Deal effectively with others in an antagonistic situation; use appropriate interpersonal styles and methods to reduce tension or conflict between two or more people.
Effectively manage one's time and resources to ensure that work is completed efficiently.
Accomplish tasks by considering all areas involved, no matter how small; showing concern for all aspects of the job; accurately checking processes and tasks; being watchful over a period of time.
Assimilate and apply new job-related information in a timely manner.
Licenses and Certifications
Certified in Healthcare Compliance (CHC)
Sedentary - Exerting up to 10lbs. occasionally or negligible weights frequently; sitting most of the time.
that Children’s Health provide for our patients and employees makes this an enjoyable place to be. As a system, there is a lot of room for professional and personal growth, with opportunities to further your education and your career.
Point of Care Coordinator