Oversee the development and maintenance of the compliance program for the UCLA Health System and the David Geffen School of Medicine including development of a risk assessment plan to determine the appropriate audit workplan for the UCLA Healthcare Hospital and Physician Compliance Workplan and activities in accordance with applicable regulatory requirements including those outlined in Office of Inspector General (OIG)'s Compliance Program Guidelines, the OIG Annual workplan, the California Medical Review Institute PEPP program, the Center for Medicare and Medicaid Services (CMS), , DHS, JCAHO and other regulatory agencies.
ADMINISTRATIVE DUTIES / ORGANIZATIONAL PLANNING
Direct the operation of the Hospital and Professional Compliance Program. Manage overall Hospital and Professional compliance staff members.
Act as liaison with Patient Business Services, Financial Services, Enterprise Coding Department, Physicians, nurses, ancillaries, Admissions, Human Resources, and others relating to hospital and physician compliance issues. Participate on multi-disciplinary teams to coordinate activities that would improve compliance efforts. work closely with the CAOs and Hospital department Managers on compliance initiatives
Maintain knowledge of and provide updates to the Compliance staff and Enterprise clients regarding r regulatory changes in compliance, health information management, release of information and patient privacy.
Develop departmental strategic initiatives, short and long-range planning, and ensuring coordination with the Medical Enterprise's strategic plan.
In conjunction with departmental, organizational, and outside entities, work to continually improve the efficiency and quality of services provided by the department and the Medical Enterprise.
Maintain department records for the Office of Compliance and Privacy and serve as the Administrator, coordinating and managing budgets, personnel issues and other administrative duties as needed relating to education, training and the department website.
Responsible for maintaining comprehensive knowledge of the Standards of Conduct as well as other related policies and procedures and their integration and interaction with one another.
Responsible for maintaining comprehensive knowledge of trends in the professional compliance industry and their applicability to the healthcare industry.
Maintain a working knowledge of relevant issues, laws and regulations as it pertains to hospital compliance.
Maintain the audit controls and measurements to ensure that the correct processes are adhered to.
Maintain knowledge of changes in national coding practices and standards, applicable federal and state privacy laws, licensing and accreditation requirements, and other applicable federal and state regulations.
Review department specific compliance plans. Provide assistance to and coordinate efforts among hospital departments to ensure overall hospital compliance plan objectives and goals are attained.
Organize and coordinate the Hospital Compliance Committee, its various taskforce groups, and the Physician Compliance and Privacy Committee. Provide support to the Enterprise Compliance committee.
Prepare required compliance report and audit reports. Maintain a tracking system to log issues and incidences with analysis and trending.
Monitor OIG and HHS releases, and incorporate changes into the compliance workplan. Communicate changes to the Compliance Officer, and applicable department administrators.
Act as liaison between compliance office and Audit and Advisory Services for compliance issues.
Monitor regulatory publications such as Local Medical Review Policies, the Federal Register, Medicare and Medicaid communications and others for changes impacting hospital compliance issues. Communicate changes to applicable department administrators