Compliance Specialist

We've made a lot of progress since opening the doors in 1942, but one thing has never changed - our commitment to serve, heal, lead, educate, and innovate.  We believe that every award earned, every record broken and every patient helped is because of the dedicated employees who fill our hallways. 

At Ochsner, whether you work with patients every day or support those who do, you are making a difference and that matters.  Come make a difference at Ochsner Health and discover your future today! 

This job assists in maintaining an effective and comprehensive system-wide compliance and privacy program, including auditing, monitoring, investigations, education, regulatory compliance, privacy, and reporting. Participates in audits, projects, and regulatory consultations for the company. Performs compliance related research, conducts and documents interviews, completes action items associated with project plans. Analyzes issues and presents oral and written conclusions to department and organization management. Serves as resource to company employees and management in applying and improving compliance policies, procedures and processes. Perform Medicare Coverage Analysis (MCA) for sponsored research projects. Configure studies in a Clinical Trial Management System (CTMS) to guide users in accurate data recording to prevent billing errors, ensuring data integrity and compliance.

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential duties.

This job description is a summary of the primary duties and responsibilities of the job and position. It is not intended to be a comprehensive or all-inclusive listing of duties and responsibilities. Contents are subject to change at the company's discretion.

Education

Required – Bachelor’s degree.

Preferred –Advanced degree in healthcare or related field.

Work Experience

Required – 2 years of experience in healthcare compliance, operations, regulatory compliance, risk management, audit, law, or related field.

Preferred – Experience with healthcare corporate compliance issues. Experience in a clinic or clinical research setting.

Certifications

Preferred – Certified in Healthcare Compliance (CHC), Certified in Healthcare Privacy Compliance (CHPC), Certified in Healthcare Research Compliance (CHRC), Certified Professional Coder (CPC), Certified Coding Specialist (CCS) or related certification.

Knowledge Skills and Abilities (KSAs)

• Proficiency in using computers, software, and web-based applications.

• Effective verbal and written communication skills and ability to present information clearly and professionally.

• Strong interpersonal and team building skills and ability to interact with individuals of diverse cultural backgrounds, of all ages, and at all levels within and outside the organization in a positive, effective manner.

• Strong organizational and prioritization skills and ability to regularly perform work under minimal supervision.

• Basic knowledge of compliance concepts, applicable laws and regulations, business risk, effective risk management techniques and auditing, and compliance's role in corporate governance and its key relationships with the audit committee, board, and executive and operating management.

• Ability to gather information, understand problems and seek out cause-and-effect relationships that identify underlying issues or problems.

• Ability to read and comprehend complex documents.

• Ability to exercise integrity and unprejudiced and unbiased judgment on behalf of the organization.

• Knowledge of Medical terminology

Job Duties

• Reviews clinical trial protocols, informed consent forms, contracts, Notices of Grant Award, FDA letters to produce a Medicare Coverage Analysis within a CTMS system.

• Creation, revision, and management of documents related to Medicare coverage analysis and compliance with Medicare rules and regulations

• Meet with research teams (Principal Investigators, Advanced Providers and study coordinators) to review the MCA analysis

• Assists in maintaining an effective compliance program by ensuring that all performance, documentation, follow-up and organization is conducted in accordance with department standards.

• Participates in projects and resolving potential compliance issues collaboratively with other departments as appropriate.

• Communicates with key stakeholders about projects to resolve issues and achieve desired corrective action.

• Supports in-services and other educational services to organization, management, and employees regarding risks, controls and compliance-related matters.

• Maintains technical compliance regulatory knowledge and acts as a resource for the organization, management, and employees.

• Pursues self-development, which is comprised of internal, external and self-administered curriculum, as well as regular reading of applicable journals, periodicals and publications.

• Performs other related duties as required. 

The above statements describe the general nature and level of work only. They are not an exhaustive list of all required responsibilities, duties, and skills. Other duties may be added, or this description amended at any time.

Remains knowledgeable on current federal, state and local laws, accreditation standards or regulatory agency requirements that apply to the assigned area of responsibility and ensures compliance with all such laws, regulations and standards.

This employer maintains and complies with its Compliance & Privacy Program and Standards of Conduct, including the immediate reporting of any known or suspected unethical or questionable behaviors or conduct; patient/employee safety, patient privacy, and/or other compliance-related concerns.

The employer is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, or disability status.

Physical and Environmental Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Medium Work - Exerting 20 to 50 pounds of force occasionally, and/or 10 to 25 pounds of force frequently, and/or greater than negligible up to 10 pounds of force constantly to move objects.   (Constantly: activity or condition exists 2/3 or more of the time) to move objects. Physical demand requirements are in excess of those for Sedentary Work. Even though the weight lifted may be only a negligible amount, a job should be rated Light Work: (1) when it requires walking or standing to a significant degree; or (2) when it requires sitting most of the time but entails pushing and/or pulling of arm or leg controls; and/or (3) when the job requires working at a production rate pace entailing the constant pushing and/or pulling of materials even though the weight of those materials is negligible. NOTE: The constant stress and strain of maintaining a production rate pace, especially in an industrial setting, can be and is physically demanding of a worker even though the amount of force exerted is negligible.

Normal routine involves no exposure to blood, body fluid or tissue and as part of their employment, incumbents are not called upon to perform or assist in emergency care or first aid.

The incumbent has no occupational risk for exposure to communicable diseases.

Because the incumbent works within a healthcare setting, there may be occupational risk for exposure to hazardous medications or hazardous waste within the environment through receipt, transport, storage, preparation, dispensing, administration, cleaning and/or disposal of contaminated waste. The risk level of exposure may increase depending on the essential job duties of the role.

Are you ready to make a difference? Apply Today!

Ochsner Health does not consider an individual an applicant until they have formally applied to the open position on this careers website.

Please refer to the job description to determine whether the position you are interested in is remote or on-site. Individuals who reside in and will work from the following areas are not eligible for remote work position: Colorado, California, Hawaii, Illinois, Maryland, Minnesota, New Jersey, New York, Vermont, Washington,and Washington D.C.

Ochsner Health endeavors to make our site accessible to all users.  If you would like to contact us regarding the accessibility of our website, or if you need an accommodation to complete the application process, please contact our HR Employee Solution Center at 504-842-4748 (select option 1) or [email protected]. This contact information is for accommodation requests only and cannot be used to inquire about the status of applications.

Ochsner is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to any legally protected class, including protected veterans and individuals with disabilities.