Analyst, Regulatory Compliance (Project Management)

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Time Type:

Full time

Department:

Legal and Government Affairs

All Locations:

300 Ocean Avenue – Revere

Position Summary:

The Regulatory Compliance Analyst will perform a wide range of business functions to ensure adherence to regulatory requirements as well as internal policies and procedures. The focus of this position will be oversight of PACE program contractual relationships, ensuring that business partners meet regulatory requirements and adhere to NeighborHealth policies and procedures in their work on behalf of NeighborHealth. This position will also play a key role in expanding contractor oversight to non-PACE contracts. The Regulatory Compliance Analyst will be responsible to identify potential business risks/barriers and develop an annual plan for auditing contractor compliance in conjunction with Corporate Compliance.

Additionally, the Regulatory Compliance Analyst will serve as the PACE Contract Liaison to establish and maintain contracts and letters of agreement as requested and coordinate the communication between Neighborhood PACE and its business partners. This position will also provide support for contract negotiation and review for non-PACE contracts as requested.

• Responsible to negotiate new contracts or letters of agreement as needed.
• Documents management of all PACE contracts, including filing and scanning in NeighborHealth's contract management system, tracking of necessary signatures and obtaining required supporting documentation to ensure contract compliance with regulatory requirements.
• In partnership with Human Resources, MSO, and Employee Health, keeps contracted staffing organizations up to date on NeighborHealth employee onboarding requirements.
• Maintains a complete list of contractors for NeighborHealth, including PACE Provider Network
• Provides support and subject matter expertise around contracting and current contractual relationships and responsibilities.

Compliance Oversight

• Under the supervision of the Director of Corporate Compliance, works closely with the PACE Compliance Committee and PACE Senior Management to create and implement a Risk Based Audit Plan for confirming contractor compliance on at least an annual basis.  
• In collaboration with PACE Quality, maintains the PACE Compliance Dashboard.
• Attends all Compliance & Risk Management Committee meetings and coordinates communication with PACE leadership regarding NeighborHealth compliance activities, audit planning and tracking, organizational risk assessments, organizational internal audit planning, and other activities related to coordinating compliance work across NeighborHealth.
• Responsible for reporting audit results and recommendations to leadership groups (Senior Manager, Compliance, etc.)
• Serves as a liaison between Compliance and subject matter expert units related to all compliance audits and business processes; may deliver difficult messages. 
• Assists in monitoring of relevant regulations and updating NeighborHealth policies, procedures, and workflows as needed to comply with changing regulations or requirements. Supports department and company strategies to ensure compliance with federal, state and contractual requirements. 
• Identifies potential areas of compliance vulnerability and risk and develops strategies for addressing these areas in partnership with other members of the Legal and Compliance team.

Education and Training Programs

• Assists in the development and distribution of training materials for staff and contractors.
• Oversees timely completion of required trainings and compliance tasks as requested.
• Coordinates with ETI to extract data reports and prepare summaries as required to inform planning.
• Assists in program-wide trainings as appropriate, as the online learning software expert user for the Compliance department.

Medicare Audits

• In partnership with the PACE Regulatory Compliance Manager, flags CMS audit compliance issues based on risk assessments and compliance monitoring to Corporate Compliance.
• Plays an active role in preparing for the CMS audit, including pre-audit issue disclosures and data submissions.
• Supports development and implementation of corrective action plans in regards to ongoing compliance monitoring and reporting; coordinates with PACE Quality Improvement team as needed.
• Assists in performing ongoing audits related to findings from CMS audits.

Other Duties and Responsibilities

• Performs other duties as requested by Director of Corporate Compliance
• Is highly professional, knowledgeable and articulate when representing NeighborHealth in organization-wide and external activities.

Other Duties & Responsibilities: Organizational Competencies

• Reads, understands and complies with all Standards of Conduct, Joint Commission standards, HRSA requirements, CMS PACE Program Regulations and Standards, applicable State regulations and guidelines, NeighborHealth and PACE policies and procedures and all laws related to position responsibilities and employment at NeighborHealth.
• Adheres to NeighborHealth standards of Employee Conduct and all related policies and procedures by:
• Demonstrating excellent customer service;
• Showing respect to other employees;
• Adhering to standards of cultural competency and non-discrimination;
• Adhering to standards of privacy;
• Adhering to attendance and other policies and utilizing appropriate notification and other procedures.
• Upholds procedures and systems to safeguard the confidentiality of all patient and employee information. 
• Upholds safety policies, practices, and procedures including safety, fire safety, electrical safety, proper body mechanics and material handling, office/ergonomic safety and other employee safety measures.
• Attends required training annually.

Teamwork experience working cross-functionally throughout multiple disciplines. Excellent communication, relationship building and interpersonal skills. Excellent organizational skills as demonstrated by prioritization and ability to work independently. Attention to detail and ability to master and apply complex and overlapping regulatory requirements.

EDUCATION: College degree or health care related certification (such as healthcare compliance certification) or equivalent experience working in a compliance role in healthcare (5 years).

EXPERIENCE: Experience in health care preferred, particularly in compliance or other administrative roles.

SKILLS/ABILITIES: Excellent interpersonal and organizational skills.  Ability to work with detailed confidential material and data.  Ability to communicate difficult messages and enforce requirements. General familiarity with technology such as Microsoft Office, Workday, electronic medical record. Epic experience preferred.

Starting salary rate: $34.00/hr. - $70,720/annually up to $53.00/hr. $110,240/annually depending on experience.