Integrity Compliance Asst Jobs

Integrity Compliance Assistant

PRN/OCC, Hours vary, Day Shift

Covenant Health Overview

Covenant Health is the region’s top-performing healthcare network with 10 hospitals, outpatient and specialty services, and Covenant Medical Group, our area’s fastest-growing physician practice division. Headquartered in Knoxville, Covenant Health is a community-owned integrated healthcare delivery system and the area’s largest employer. Our more than 11,000 employees, volunteers, and 1,500 affiliated physicians are dedicated to improving the quality of life for the more than two million patients and families we serve every year. Covenant Health is the only healthcare system in East Tennessee to be named a Forbes “Best Employer” seven times.

Position Summary

Provide research and development along with coordination of projects that support the Covenant Health Integrity-Compliance program initiative as outlined in The Integrity-Compliance Plan for Covenant Health and approved by the Covenant Health Board of Directors as well as providing administrative and clerical support to the Integrity Compliance Officer.

Recruiter Kathleen Rice || [email protected] || 865-374-5391

• Assist with selection and establishment of electronic tracking system for Report Line cases.
• Research and develop materials for system wide policies to provide guidance for management, medical staff and individual departments as appropriate on compliance standards.
• Conducts aspects of background checks on selected Covenant Health staff members.
• Coordinates the Integrity-Compliance Officer schedule, arrange meetings, appointments, and organize travel arrangements. Prepares agenda materials.
• Coordinate with appropriate persons to ensure prehire, contract execution and renewal, periodic comparisons and cost report auditing reviews of the GSA/OIG Sanctions Listings are preformed. All identified as appearing on the Sanctions report will be submitted to the I-C Office, logged and verified through the HCFA Office of Inspector General.
• Opens and screens incoming mail. Locates and attaches appropriate file to correspondence to be answered.
• Responsible for Report Line coverage, assessment and action planning for incoming cases.
• Communication Must demonstrate effective communication skill on all socio-economic levels using tact, articulate, and professional demeanor.
• Assist in development and preparation of annual training content and scheduling. Responsible for ensuring data entry and providing periodic reports. Provides support for training initiative.
• Management Must meet Covenant Health standards for management of the work involved in the job. May be required to manage the work of 1 to 2 other employees or contractors.
• Participates on committees and task forces as assigned.
• All other duties as assigned or requested.
• Coordinates activities with internal and external resources
• Act as point of contact for identifying contractual relationships with Disqualified Persons/Related Parties and initiate review of identified contracts for appropriateness.
• Design, select, implement and maintain databases and information relative to mandatory annual training, report line call volume and cataloging, report line call file tracking, OIG/GSA Sanctions Listings, Management Certification and Disqualified Persons/Related Parties.
• Customer Service Must be able to practice, teach and effectively apply Covenant Health customer service standards.
• Maintains and orders office supplies as necessary.
• Attendance Attendance must be almost perfect.
• Working With Others Must posses an extremely pleasant, courteous, efficient and helpful attitude; excellent ability to communicate, and, the ability to work closely and cooperatively in person and over the telephone with a variety of people. Will work alone for hours at a time.
• Receives and screens telephone calls and may respond to complex inquiries. Takes messages and/or redirects callers.
• Monitor and distribute information found on 15+ web sites and other resource locations for federal and state healthcare program laws, regulations and rules. Topics include but are not limited to HIPPA, Medicare, Fraud and Abuse, Coding Requirements, Claims submission Process, Marketing Practices, Antitrust, Taxation, Antireferral, etc.
• Coordinate with appropriate persons to ensure all employees, contractors, and agents as stated in the Covenant Health Code of Conduct attend mandatory Integrity-Compliance Training.
• Prepare periodic program assessments for the Covenant Health Board of Directors, Integrity-Compliance Oversight Committee, Integrity-Compliance Business Unit Liaisons, and Business Unit Chief Administrative Officers.
• Equipment Position requires the working knowledge of (1) Typewriter, (2) Stand alone and networked computer systems, (3) Stand alone and networked telephone systems including conferencing features, (4) Personal Pagers, (5) Facsimile systems, (6) Independent Copiers and Copier Systems, (7) Calculators, (8) Shredders, (9) Dictating Systems.
• Keeps informed about trends in Integrity-Compliance affecting Covenant Health through participation in education programs and reading of current literature concerning health care.
• Confidentially Without fail ability to keep all information moving into and out of the Integrity-Compliance Office confidential at all times.
• Provides and helps maintain effective communication with all Covenant Health Business Units, contractors, and regulatory agencies. Works closely with Human Resources, Internal Audit, and Finance at both Corporate and Business Unit levels.
• Review, revise and update The Integrity-Compliance Plan of Covenant Health, Code of Conduct, Integrity-Compliance Charters and Policies and Procedures as maintained on the Outlook Exchange public folders and the Covenant Health Intranet.
• Composes correspondence, memoranda, and reports as necessary. Types and proofs a variety of material, i.e., committee minutes and reports to the Integrity-Compliance Oversight Committee, Board of Directors and others as necessary.
• Initiate investigations, monitors follow-up of open investigations and maintain investigation files and record of closed investigations.
• Pace of Work Must be able to work effectively in a deadline-paced environment.
• Flexibility Must have the ability to remain mentally alert and maintain concentration with attention to detail in periods of activity that range from low to high activity and stress. Must demonstrate adaptability, initiative persistence, and efficiently of time management and action.
• Judgment Must have the judgment to decide on appropriate release of information and analyze situations for application of appropriate action when called on to do independently.
• Organizes and maintains office records and information with strictest confidence.
• Travel Occasionally required to travel to various Covenant sites to assist with training and investigations.
• Attends educational offerings to enhance professional growth and development to gain and share information regarding Health System operations. May be required to conduct training sessions as needed.

Minimum Education Knowledge base equivalent to an associate degree in business administration. Successful completion of course work or experience that prepares for communicating with the public particularly in managing patient, customer, client satisfaction issues; office management; maintaining/ordering office supplies; balancing a budget; operating a computer; and other office machines and communication instruments.

Minimum Experience Minimum of three (3) years-administrative office management is required. Knowledge of medical and legal terminology; knowledge of principles of financial management; human resources; quality improvement; risk management, auditing; federal regulations. Ability to communicate, facilitate, and initiate positive employee and customer relations is required. Ability to exercise sound judgment to determine the seriousness of Guideline call issues and select an appropriate course of investigative action. Broad familiarity with company policy and practice, including, for example Human Resources, Integrity and regulatory policies, internal audit, risk management, budgeting, and financial policies. Excellent organizational and follow-up skills; good listening skills; must be able to communicate effectively both verbally and in writing. Requires familiarity with legal issues and filing/record keeping systems. Ability to handle confidential information appropriately.

Licensure Requirement None