The primary responsibilities include supporting the administration of our Compliance program, HIPAA-compliant records request process, the company's Compliance Hotline, credentialing of outside healthcare providers in our facilities, and creating and administering reports and trainings to help facility and regional-level teams improve their performance.

Essential Functions

Compliance Hotline Administration: Manage and monitor the company's third-party Compliance Hotline, ensuring it is available 24/7. Respond to and document compliance concerns and inquiries and escalate issues as necessary. As directed, assist in the review/analysis of HIPAA-compliance for records requests, and administer the process to ensure secure and compliant production of records As directed, participate in the credentialing process for outside healthcare providers, ensuring all necessary documentation and qualifications are verified and maintained. Review Medical Director time logs for accuracy and compliance with contractual requirements; maintain an ongoing tracking log to support oversight and reporting. Reporting: Create and administer detailed reports to track compliance issues, hotline metrics, credentialing status, and performance metrics. Provide insights and recommendations to facility and regional-level teams to improve compliance and operational performance. Policy Implementation: Assist in the development and implementation of compliance policies and procedures to ensure adherence to regulatory requirements and company standards. Training and Education: Support the development and delivery of compliance training programs for staff and healthcare providers. Collaboration: Work closely with various departments, including Legal, Clinical, IT, Finance, Operations, and Human Resources, to address compliance issues and implement corrective actions. Regulatory Updates: Stay current with changes in healthcare regulations and ensure the company’s compliance programs are updated accordingly. Support: Will assist other compliance functions as needed in support of particular initiatives or projects 
 

Educational/Training Requirements

Bachelor's degree in healthcare administration, business, or a related field; certification in compliance or credentialing preferred. Strong understanding of healthcare regulations and compliance requirements. Excellent organizational, analytical, and communication skills.  Ability to work independently and manage multiple tasks simultaneously. Proficiency in Microsoft Office Suite and compliance management software. Willingness to travel occasionally as required.

Licensing Requirements

Certification in compliance or credentialing preferred

Experience Requirements

Minimum of 3 years of experience in compliance, credentialing, or a related field, preferably in the healthcare or long-term care industry.

Strong preference for candidates located in Texas