Senior Compliance Analyst

Atlanta, GA | Legal & Compliance

Position Summary:

GoHealth Urgent Care partners with healthcare systems across the country to provide unparalleled experiences for our customers, employees, partners and community. We live our values of innovation, collaboration, diversity/inclusion, courage/integrity and accountability. We believe in promoting from within and the value of each team member. Check us out as we are growing and in need of professionals whose mission and values coincide with GoHealth! 
 
The Senior Compliance Analyst is an important strategic leader within the Compliance Department in the areas of incident resolution and prevention, audit, policy development, risk assessment, regulatory research, and work plan projects in an outpatient, urgent care office setting. The incumbent may also assist with the review and resolution conflict of interest and other regulatory matters. The incumbent will be responsible for management of assigned internal compliance audits, recommendation and oversight of corrective action plans, and compliance education. The incumbent will interact with internal and external compliance stakeholders and must be critical-thinking, thorough, and solutions-focused. 
 
JOB REQUIREMENTS
 
Education
  • Bachelor’s degree in health/public/business administration, public policy, health information management, or related field required.
  • Advanced degree in a related field (such as MHA, MPA, MBA, JD) preferred.
Work Experience 
  • 4+ years’ experience in a healthcare (or translatable) setting with compliance programs, regulatory research, auditing, and/or policy and procedure development required. 
  • Compliance investigation experience
  • Experience in management of compliance programs preferred. 
Required Licenses/Certifications
  • Certified in Healthcare Compliance (CHC) desired at time of or within 18 months of hire.
  • Other desired certifications: Certified in Healthcare Privacy Compliance (CHPC); Certified Professional Coder (CPC); Certified Coding Specialist (CCS). 
Additional Knowledge, Skills and Abilities Required
  • Self-starter with attention to detail and ability to manage multiple projects, delivering timely, exceptional, and thorough work products
  • Ability to be a strategic thinker within the Compliance Department and provide guidance and direction on department initiatives
  • Desire to continue to expand skill sets and experience and willingness to take on new projects 
  • Excellent interpersonal, written, and verbal communication skills
  • Ability to perform independent research and factual analysis of compliance matters and create proposed solutions to root causes 
  • Ability to function within a fast-paced, dynamic, and growing environment
  • Ability to maintain patient confidentiality 
  • Familiarity of federal and state regulations, such as False Claims Act, Stark Law, Anti-Kickback Statute, Civil Monetary Penalties Law, and HIPAA
Additional Knowledge, Skills, and Abilities Preferred 
  • Epic or eClinicalWorks EMR experience 
  • Proficiency with Microsoft Word, Excel, and SharePoint 
  • Policy and procedure development
  • Familiarity of Medicare and Medicaid billing rules and guidelines, CPT and ICD coding guidelines
ESSENTIAL FUNCTIONS
  • Independently manage all aspects of compliance education, sanction screenings, incident investigation and response, and assigned audit projects. Deliver exceptional work products for these subject areas.
  • Create and lead teams to address and resolve compliance matters in an effective and efficient manner.
  • Uphold compliant and ethical behavior in all situations and be an ambassador at all times for the Compliance Program. 
  • Address and resolve privacy matters, including coordination of notification and follow up.
  • Perform internal audits and reviews of processes in a thorough and structured manner. 
  • Review of billing/reimbursement activities and application of CPT, ICD, Medicare NCDs/LCDs rules.
  • Create collaborative, effective workgroups of internal and external stake holders.
  • Research, synthesize, and apply various complex state and federal healthcare regulations.
  • Create audit reports, policies and procedures, or other department communications.
  • Data analysis, including ability to manipulate data in Microsoft Excel and Access.
  • Participation in and contribution to the risk assessment and work plan creation process.
  • Verbal communication and ability to present compliance education to various audiences.
  • Strong customer service acumen in responding to and dealing with both internal and external stakeholders. 
  • Organize, track, and resolve compliance matters as they arise.
  • Perform exclusion screening of employees and vendors against OIG, SAM, and state Medicaid exclusion lists.
  • Facilitate, plan, and coordinate compliance meetings with internal and external stakeholders.
All other duties as assigned.
 
Note: this job description is not inclusive of all the duties of the position. You may be asked by leaders to perform other duties. Management reserves the right to revise this position description at any time.

All qualified persons are granted an equal opportunity for employment without regard to race, color, religion, sex, sexual orientation and gender identity or expression, age, national origin, citizenship status, disability, genetic information, medical condition, family care leave status, pregnancy or pregnancy-related condition, otherwise qualified disabled or veteran status. The company will comply with all fair employment laws in each of the jurisdictions where we conduct business.


Keywords:
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Why GoHealth?

GoHealth Urgent Care has outstanding career opportunities in Connecticut, Delaware, Missouri, New York City, North Carolina, Northwest Arkansas, Oklahoma City, San Francisco and the Portland-Vancouver area. And all of these positions have one thing in common: flexibility to practice urgent care medicine the way it was meant to be, without the stress and bureaucracy of hierarchical organizations. With reasonable work hours that don’t emotionally exhaust them or burn them out, our team can balance and prioritize their professional and personal lives.

The lifestyle you can lead.

Atlanta is Georgia’s state capital and home to approximately half a million residents. Well known for its arts, theater, galleries and museums, cultural attractions, and institutions of higher education, Atlanta offers many things to do. Visit Georgia Aquarium, the largest public aquarium in the Western Hemisphere. Shop and enjoy great entertainment in Underground Atlanta. See wildlife shows at Zoo Atlanta. Catch a pro football, basketball or baseball game. Foodies will delight in local favorites, such as crab fritters, chicken biscuits, pulled pork sandwiches and salted caramel ice cream. Choose from many welcoming neighborhoods to live in, from downtown and midtown to Chastain Park, and from Buckhead to Cabbagetown, Kirkwood and Morningside. There’s also a good selection of public and private schools and nearby colleges and universities. Public transportation is excellent, and Atlanta is also served by Amtrak and Hartsfield-Jackson Atlanta International Airport.