COMPLIANCE COORDINATOR JOB SUMMARY

This position works as the primary liaison between Comprehensive Community Health Centers (CCHC) and its contracted IPAs and health plans, serves as CCHC's in-house contract expert, reviews and supports implementation of regulatory guidance or laws, and serves as the CCHC's Privacy Officer.

COMPLIANCE COORDINATOR ESSENTIAL DUTIES AND RESPONSIBILITIES

• Develops and maintains positive relationships with IPAs and health plans by conducting over-the-phone and on-site meetings, and leading joint operating committee (JOC) meetings with IPA and health plan representatives on a regular basis.
• Addresses operational issues between CCHC and IPAs and health plans regarding claim submissions, authorization issues, provider contracting issues, credentialing issues, and other issues as directed.
• Reviews and negotiates/re-negotiates IPA and Plan contracts.
• Reviews and negotiates provider and vendor contracts.
• Reviews and negotiates all internship, externship, volunteer agreements with educational institutions and programs
• Remains current and up to date on IPA, health plan and other state and federal legislation, including HRSA requirements, impacting CCHC. Includes but is not limited to interpreting guidelines, disseminating information to other CCHC Department Heads and providers, training staff on new requirements, and developing policies and procedures to support new or changing requirements.
• Ensures adherence with federal and state regulations and accreditation standards.
• Responsibilities also include operating, overseeing, and modifying CCHC's Compliance Program, and internal monitoring of CCHC operations for compliance purposes.
• Responsible for working with legal counsel, when directed by CAO.
• Establishes and maintains required language, contract provisions and terms for all agreements entered into by CCHC
• Identify information security, confidentiality and release of patient information/HIPAA issues.
• Serves as CCHC's Privacy Officer
• Provide administrative support to Compliance Department, including preparation for the Board of Directors quarterly Compliance Committee meeting.
• Coordinates with CCHC's Credentialing Department and periodically assists the Revenue Cycle (Billing) Department with auditing and troubleshooting of provider data to ensure proper claims adjudication
• Performs other duties as assigned or requested.

COMPLIANCE COORDINATOR EDUCATION AND EXPERIENCE

• Bachelor's degree in Business Administration, Health Care Administration or other-related field preferred.
• 3-5 years-experience in the health care-related contracting.
• General knowledge of guidelines and regulations specific to the health care field
• Paralegal or contracting experience is desired but not required

COMPLIANCE COORDINATOR PAY RATE: $33-$36/hr

COMPLIANCE COORDINATOR BENEFITS:

• Medical, Dental and Vision - 100% paid by Employer
• Life Insurance and Accidental Dismemberment - 100% paid by Employer
• Paid Holidays
• Paid Time Off
• 401K
• 401K Matching
• Flexible Spending Account
• Fringe
• Supplemental Insurance

NOTE: The essential job functions for this position include, but may not be limited to those listed in this job description. Employees hired for this position must be able to perform the essential functions of this job without imposing significant risk of substantial harm to the health or safety of themselves or others

PI14522dc6a0bb-29448-36161279