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Compliance Manager

Company: Cano Health
Location: Miami
Posted on: February 25, 2021

Job Description:

The Health Care Compliance Manager will report directly to the Chief Compliance Officer and will be responsible for the day-to-day operations of the corporate compliance program. Specifically, the Health Care Compliance Manager will assist the Chief Compliance Officer to ensure compliance program integrity by engaging in the following activities:1. Develop and implement programs to prevent, detect and respond to internal and external compliance risks and conduct enterprise risk assessments, investigations and risk mitigation.2. Work collaboratively with administrative and clinical leadership and assist with the development of operational controls and effective processes and practices that demonstrate appropriate execution of compliance regulatory requirements.3. Develop and implement written standards of conduct, policies and procedures that promote the organization's commitment to compliance.4. Prepare for and engage in regular compliance committee meetings.5. Oversee and manage the implementation of the corporate compliance program including effective compliance training and education.6. Oversee and manage the compliance hotline and processes to ensure effective communication to receive and resolve complaints and concerns.7. Develop and manage policies and processes to investigate and respond to allegations of improper or illegal activities.8. Develop and implement audit and risk programs and monitor to ensure compliance with applicable regulations, policies and the OIG elements of an effective compliance program.9. Implement processes to ensure non-employment/engagement--of individuals or entities excluded from participation in federal health care programs (sanction checking).10. Research and provide analysis on federal and state laws and regulations.11. Develop standards to measure Compliance Program effectiveness and work continuously to improve program effectiveness.12. Compile, analyze and integrate reports, spreadsheets, benchmarks, data and metrics for continuous improvement of the Compliance Program.13. Develop tools, forms, and educational materials to track, manage and improve organizational Compliance Program performance.14. Assist organizational administrative and clinical leadership with compliance matters to ensure a culture of compliance.15. Stay current with applicable government rules and regulations and maintain current compliance information, including OIG model compliance guidance, Advisory Opinions, Fraud Alerts, Bulletins, False Claims Act, Stark, Anti-Kickback, Conflict of Interest, HIPAA, and other applicable laws and regulations.16. Develop long-range and short-term goals, objectives and plans to assure the development, implementation, maintenance and improvement of compliance effectiveness.17. Conduct complex investigations of allegations of regulatory and compliance violations, manage and maintain case report documentation, develop mitigation plans and make corrective action recommendations to organizational leadership, conduct follow up and monitor activities.18. Conduct investigations and prepare formal responses to external federal and state investigation and develop corrective action plans and subsequent monitoring plans.19. Maintain compliance program files and records of all audits, investigations, lawsuits and complaints, incident reports, compliance training, risk analysis, and other compliance program activities. 20. Work with outside counsel and manage third party compliance program vendors.21. Prepare and implement quarterly and annual Compliance and Audit Work plans based upon evaluation of current risks facing the organization.22. Track and trend and develop systems to track and trend compliance activities.23. Other duties as assigned. Experience:Bachelors Degree required. Minimum 3 years health care compliance experience required. Knowledge of health care laws required. Florida AHCA and/or other state health care regulatory agencies, Primary Care, Managed Care, Hospital or Physician's Office experience preferred.

Keywords: Cano Health, Miami , Compliance Manager, Executive , Miami, Florida

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