Intermountain Healthcare Compliance Consultant Associate - SelectHealth in Salt Lake City, Utah
Greater Salt Lake area
What does it mean to be a part of Intermountain Healthcare? It means that the quest for clinical excellence is not just a goal, but a given. It means building an environment where physicians and employees can deliver the best in healthcare. And it’s realizing each employee or volunteer is vital to the healing process, because we can only achieve theextraordinary together .
Being a part of Intermountain Healthcare means joining with a world-class team of over 36,000 employees and embarking on a career filled with opportunities, strength, innovation, and fulfillment. Our mission is: Helping people live the healthiest lives possible.
Our patients deserve the best in healthcare, and we deliver.
This position may be hired as a Compliance Consultant Associate, Staff, or Senior depending on experience.
This position serves as a resource for the implementation and maintenance of a coordinated and integrated Compliance Program at Intermountain Healthcare. This position demonstrates an understanding of the regulations that govern healthcare and works to ensure compliance with those regulations. This position investigates issues and works with others to resolve those issues, provides education and information, assesses risks, and monitors outcomes. The compliance consultants are typically assigned to work in a specific area of focus such as coding, privacy, clinical or policy compliance.
Essential Job Duties
- 1. Maintains a broad working knowledge in all health care regulations and understanding of health care regulations. Continually improves knowledge of regulatory changes. Serves as a resource for all clinical / regional and corporate entities regarding compliance needs and regulation requirements.
- 2. Partners with operational / clinical / regional and corporate groups to conduct monitoring activities, implement corrective action plans, and evaluate effectiveness of such. Assesses various aspects of documentation as required by federal, state and other regulatory agencies for reimbursement and patient safety. Measures (survey, monitor, and report) compliance to federal, state and regulatory agency (ie: Conditions of Participation/JC) requirements for reimbursement and patient safety
- 3. Coordinates across disciplines to ensure that stakeholders are involved in the early planning stages and implementation of federal, state and other regulatory requirements for changes in documentation and work flow processes (i.e.: case management, clinical support services, nursing, Revenue Integrity, Patient Account Services, Quality, Risk, etc.).
- 4. May work with various departments and functions within SelectHealth to identify and resolve issues and create options for compliance implementation.
- 5. Participates in assessing and mitigating risk. Assists in the remediation of acute and chronic issues reported to Compliance (i.e., via Remedy) to decrease risk.
- 6. Serves as a subject matter expert and resource to others and may act as an advisor for the compliance department, specifically to be utilized in response to Government Enforcement Response activities, proactive and reactive.
- 7. Analyzes the results of internal and external compliance audits, and utilizes this information to focus on education and implementation of corrective action plans to improve overall processes and documentation accuracy throughout the system
- 8. Manages projects and oversees programs that overlap between several operational, clinical or business areas, ensuring that processes are efficient.
- 9. Coordinates with the Central Appeals Unit to determine which cases and issues are appropriate for appeal in order to recover appropriate reimbursement.
- 10. Assists in developing quality improvement plans.
- 11. Conducts training sessions and audits of operational areas to assess and improve understanding of compliance provisions applicable to operational areas by staff, and tests procedures to ensure compliance with those provisions.
- 12. May be assigned to answer and monitor the compliance hotline, and records and monitors compliance reports.
- Benefits Eligible: Yes
- Shift Details: Full-time Exempt. 40 hours per week, Monday through Friday business hours.
- Department: SelectHealth - Compliance/Contracts, located in Murray, Utah.
- Additional Details: Two positions available.
- Bachelor's Degree. Degree must be obtained through an accredited institution. Education is verified. or Five years of professional experience working in compliance related roles.
- Four years of experience working in healthcare, operations, legal, insurance or regulatory-related roles requiring effective problem solving and analytical skills.
- Experience managing projects that require strong interpersonal and organizational skills and the ability to perform under stress and to meet deadlines.
- Experience in a role requiring knowledge of, and experience with, health care regulations.
- Experience in a role requiring the demonstrated ability to effectively and confidentiality advise and interact with all levels of personnel as well as experience dealing with highly sensitive and confidential material and adhering to data security and confidentiality protocols and procedures.
- Experience using word processing, spreadsheet, database, internet and e-mail and scheduling applications.
- Experience in a role requiring effective verbal, written and interpersonal communication skills.
- Ability to travel to Intermountain facilities throughout the state on occasion.
- Interact with others requiring the employee to communicate information.
- Operate computers and other office equipment requiring the ability to move fingers and hands.
- See and read computer monitors and documents.
- Remain sitting or standing for long periods of time to perform work on a computer, telephone, or other equipment.
- SelectHealth experience
- Coding Certification CPC, CPC-H, or CCS/CCA certification
- Experience in the assigned are of focus (clinical, regulatory, insurance, coding / billing).
- Experience training others
- Professional writing experience including writing reports, summaries, and arguments for various audiences
- Experience in researching and interpreting statutory and regulator requirements
All positions subject to close without notice. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.
Working Hours 40
Primary Work Location SelectHealth
Expertise Business / Administration
Job Type Full Time
Location US-UT-Murray, US-UT-Salt Lake City