Compliance Officer

Posit ion Summary :

The Compliance Officer promotes the Tohono O'odham Nation Health Care's culture that encourages ethical conduct and commitment to compliance and ensures due diligence to prevent and detect illegal conduct. The work involves investigation and analysis of a variety of compliance issues throughout the Nation's hospital and clinics.

Scope of W ork :

Investigation and analysis projected for proposed and existing TONHC programs for efficiency, effectiveness, and compliance with regulatory and legal requirements. Develops internal controls that adequately measures and manages risks and includes standards, procedures, capable of reducing the prospect of criminal conduct. The incumbent is under the Quality Management Division reporting to the Quality Assurance Officer.

Essent ial Dut ies and Responsibilit ies :

Organization - 50%

• Exercises oversight responsibility for the TONHC compliance and integrity Uses the TONHC Compliance Plan, Federal Sentencing Guidelines, and the Office of Inspector General (OIG) Program guides to implement oversight functions.
• Recommends Compliance Program revisions to meet changes in the organization's needs, business, and regulatory environment, to improve its effectiveness.
• Provides compliance information to help TONHC management find new ways to improve decision making, quality, and reduce its vulnerability to fraud, waste, and abuse.
• Ensures that independent contractors and agents who provide medical services are educated and aware of the TONHC Compliance Plan.
• Researches and assists in applying regulatory compliance requirements.
• Works closely with Chief Legal Officer (CLO), when appropriate to review investigations that result in violations of law that may require reporting to the Office of the Inspector General (OIG), appropriate agencies or fiscal intermediary.
• Conducts investigations of alleged violations of law, standards of conduct, or any other system policies and procedures within TONHC.
• Responds to employees by ensuring that reports (phone calls, emails, and interoffice mail) are appropriately investigated and resolved. The Compliance Officer will ensure reports remain anonymous or confidential to the extent possible.
• Implements, documents and maintains a coordinated legislative and regulatory compliance program that meets the expectations of Tribal, State and Federal regulators and Government programs.
• Stays abreast of changes to and clarifications of Federal Guidelines regarding meaningful use and EHR certification criteria. I n reference to compliance, will be responsible for developing tools to monitor and devise reporting mechanisms for high-risk areas identified in audits for TONHC.
• Serves as the chairperson of the compliance Develops agendas, reports, and information as requested by the committee, CEO and Governing Body.
• Manages the compliance department's administrative This includes organizing and maintaining relevant files, preparing necessary reports on activities and reporting to various TONHC committees.
• Effectively incorporates the compliance program organizational committee reporting structure. This requirement will also consist of appropriate information and reporting system so that the CEO and Governing Body may exercise timely and informed judgments concerning the health care's compliance with applicable law.
• Coordinates resources to ensure ongoing effectiveness of the compliance program.
• Ensures coordination with other departments including the Revenue Enhancement Branch, Human Resources, Information Technology and Clinical Services to ensure effective implementation of TONHC's commitment to compliance and integrity.
• Reports directly to the TONHC Quality Assurance Officer who will ensure that the CEO and the Governing Body are kept apprised regarding compliance matters.
• Stops submission of data that he / she believes contains material errors.

Communication and Training 20%

Monitoring, Auditing and Enforcement - 20 %

Policies, Procedures and Standards - 10%

Know ledge, Sk ills, and Abilit ies :

M inim um Qualificat ions :

Licenses, Cert ificat ions, Special Requirem ent s :

Physical Dem ands :

Work is sedentary with some walking, bending, stooping. The work may require long periods of sitting and operating a personal computer. Standing for several hours may be required when conducting training sessions and workshops. Work areas are in different geographic areas (Sells Hospital, San Xavier, Santa Rosa, and San Simon Health Centers). The incumbent must work at all areas on a frequent basis.

W ork Environm ent

Work is performed in a typical office setting. Work is primarily sedentary, although some physical effort may be required. I ncumbent is required to operate a government vehicle in the performance of assigned duties under a variety of road and weather conditions and maintain a valid state driver's license.

This list of duties and responsibilities is illustrative only of the tasks performed by this position and is not all inclusive.