Compliance Program Manager – Riverside

Riverside University Health System (RUHS) seeks candidates for an RUHS Compliance Program Manager position. This role supports the development, coordination, implementation, and oversight of RUHS corporate compliance programs and activities. The selected candidate will supervise support staff, ensure adherence to applicable regulations, and perform related duties as required.

Current certification in Healthcare Privacy Compliance (CHPC) is strongly preferred.

Key responsibilities include:

• Supporting compliance with federal, state, and county laws and regulations, including HITECH.
• Providing subject matter expertise on medical privacy and information security.
• Overseeing staff and managing program activities as assigned.
• Assisting in achieving compliance goals and strategic objectives.

The RUHS Compliance Program Manager is a journey-level manager classification reporting to the RUHS/County Compliance and Privacy Officer. Incumbents are expected to perform complex and increasingly responsible work with minimal supervision, contributing to the design, execution, and monitoring of effective compliance programs.

Examples of essential duties:

• Perform audits to assess compliance with various laws, regulations, policies, and standards such as those related to healthcare fraud, waste and abuse, billing and coding, clinical documentation, privacy and information security, research and ethics; maintain a system of reporting that provides timely and relevant information of all aspects of compliance issues.
• Participate in appropriate level of response, develop corrective action plans and conduct compliance investigations while maintaining confidentiality of information reported, as appropriate.
• Evaluate departmental continuous readiness to achieve compliance in the areas of healthcare privacy and security; assist in the development and implementation of privacy policies, procedures and breach notification as necessary.
• Develop and implement policies and procedures for filing and investigation of complaints related to HIPAA/HITECH Privacy, Breach Notification Rules and related County guidelines and procedures.
• Develop and monitor policies and procedures that establish standards for ensuring patient privacy protections, including by providing guidance to individual employees and departments on the HIPAA Privacy Rule, as appropriate.
• Document and retain all complaints received as required by HIPAA/HITECH; establish and maintain a mechanism for tracking and reporting the investigation and resolving such complaints.
• Develop and administer training for RUHS staff to promote awareness of compliance to regulatory standards.
• Provide guidance and assistance to departments on a variety of privacy and compliance auditing, and internal control matters; document findings and prepare reports.
• Supervise, assign, review, and evaluate the work performed by staff; direct the day-to-day operations of support staff.

Minimum qualifications:

• Education: Graduation from an accredited college or university with a bachelor’s degree, preferably with a major in business administration, public administration, public health nursing, finance, accounting, or a closely related field to the assignment. (A master’s degree from an accredited college or university in any of the aforementioned majors is preferred.) Possession of current Healthcare Privacy Compliance (CHPC) certification is preferred.
• Experience: Three years of professional, journey-level experience in healthcare compliance, which includes internal auditing experience and experience in the development and implementation of HIPAA and/or privacy compliance programs.

Knowledge of:

• Information security; theory, principles and practices of general healthcare; governmental accounting, budgeting and auditing; HIPAA privacy and security rules and regulations; privacy laws, rules and regulations relating to information and security; federal, state and local codes, rules and regulations including healthcare fiscal operations; the methods of developing systems forms for various types of accounting records and reports; information systems and their application to accounting operations; the principles, methods and techniques of public administration, personnel and business office management; the principles and techniques of supervision.

Ability to:

• Develop and implement compliance and auditing programs; apply legal and administrative compliance policies to hospital or health systems; analyze data, draw logical conclusions, conduct independent audits, reviews, and make evaluations to ensure compliance issues and concerns are appropriately evaluated, investigated and resolved; recommend effective courses of action; communicate effectively in oral and written form; establish and maintain effective working relationships; conduct independent systems analyses of complex business processes.