Easter Seals Jobs

Description

We are on the lookout for a meticulous program integrity professional to strengthen our team. This role will primarily focus on healthcare Medicaid HIPAA compliance. The Director of Program Integrity will be responsible for managing compliance functions, working with government healthcare programs, and executing enterprise risk management processes. This role will also require conducting operational audits for healthcare organizations.

• Oversee and manage compliance functions within the healthcare sector.

• Work closely with government healthcare programs to ensure adherence to regulations and standards.

• Demonstrate a strong understanding of Medicaid regulations and apply this knowledge in daily operations.

• Maintain a thorough understanding of HIPAA and other applicable federal and state regulations and ensure compliance across all operations.

• Execute enterprise risk management processes effectively and efficiently.

• Conduct operational audits for healthcare organizations, ensuring all processes meet regulatory standards.

• Utilize knowledge and skills obtained from being a Certified Regulatory Compliance Manager (CRCM) to enhance compliance processes.

• Leverage expertise in Health Care Audits - Medicare - Medicaid to improve operations and compliance.

• Utilize strong understanding of Health & Health Care Law to ensure the organization's operations are within legal boundaries.

• Ensure HIPAA Compliance - Patient Privacy Rule is upheld across all operations.

Requirements • A minimum of 10 years of experience in a compliance role, preferably within the healthcare sector

• Demonstrated expertise in Medicaid regulation, Medicaid program and Medicaid application processes

• Solid understanding of Health Care Audits, especially those involving Medicare and Medicaid

• Proven experience in HIPAA Compliance, specifically the Patient Privacy Rule

• Familiarity with HIPAA-regulated procedures and practices

• Knowledge of Health & Health Care Law is essential

• Ability to interpret and implement complex healthcare regulations effectively

• Excellent communication and interpersonal skills to interact with various stakeholders

• Strong analytical skills to identify potential compliance risks and develop mitigation strategies

• Bachelor's degree in law, business administration, healthcare administration, or a related field is preferred. Advanced degrees or compliance certifications would be advantageous.

• High ethical standards and professionalism, with a commitment to confidentiality and integrity.

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