Compliance and Risk Analyst

ABOUT US:

Community health is about more than just vaccines and checkups. It’s about giving people the resources they need to live their best lives. At Neighborhood, this is our vision:  a community where everyone is healthy and happy. We’re with you every step of the way, with the care you need for each of life’s chapters. At Neighborhood, we are Better Together.

As a private, non-profit 501(C) (3) community health organization, we serve over 414,000 medical, dental, and behavioral health visits from more than 95,000 people annually. We do this in pursuit of our mission to improve the health and happiness of the communities we serve by providing quality care to all, regardless of situation or circumstance.

Since 1969,  our employees have been making this mission a reality.  Regardless of the role, our team focuses on being compassionate, having integrity, being professional, always collaborating, and consistently going above and beyond.  If this sounds like an organization you would like to be a part of, we would love to meet you.

ROLE OVERVIEW and PURPOSE

The Compliance and Risk Analyst plays a pivotal role in upholding Neighborhood’s policy expectations and patient safety standards. This role involves meticulous documentation, tracking of information, initiative-taking, and collaboration with all departments, complaints processing, comprehensive data collection and analysis, and active participation in maintaining organizational standards. Additionally, this role will engage in frequent communication and presentations to stakeholders by facilitating communication and awareness across various levels of the organization. Assist with oversight and management of patient and staff safety activities, incident management, and compliance and risk management.

RESPONSIBILITIES

• Meets the organization’s customer services standards, including interpersonal communication and professional conduct expectations.
• Reviews all incident reports and manages the incident reporting database daily.
• Optimizes the use of the Compliance department software to manage compliance and risk related requirements.
• Provides internal customer service support regarding incident management through email, in person, telephone, the electronic medical record system or the Compliance software as needed.
• Investigates all reported incidents, working closely with the Compliance Manager, Operations Leadership and Medical Staff Leadership.
• Interviews staff and personnel involved in or as witnesses to the reported incident and documents all communication in the incident management system.
• Provides ongoing assistance to employees with incident reporting.
• Maintains an updated incident reporting system, uploads supporting documentation and closes out each incident timely.
• Responds timely with updates to all incident reporters with status of the open incident.
• Communicates directly with patients as needed to resolve reported incidents.
• Obtains input from medical staff leadership on clinical related issues.
• Collaborates with leadership and human resources as necessary to determine corrective action plans.
• Identifies training required for each incident.
• Assists Compliance Manager with preparing compliance and risk related policies and procedures.
• Prepares reports for Compliance Department leadership as needed.
• Creates and delivers compliance and risk related training as directed by Compliance leadership.
• Analyzes reports to identify trends and high risks, and the need for additional assessments.
• Maintains interdepartmental lines of communication.
• Assists with preparation of the annual FTCA application as needed.
• Monitors key metrics using dashboard tools designed for tracking performance, ensuring alignment with regulatory requirements, and best practices.
• Gathers, organizes, and enters data tailored to the unique data requirements of the compliance and risk programs.
• Conducts thorough analyses of collected data independently to identify emerging trends, areas for improvement, and potential risks specific to Neighborhood.
• Provides support for compliance initiatives and addressing specific regulatory and risk management needs of Neighborhood.
• Assists the Compliance department leadership in the development, implementation, and refinement of compliance and risk-related policies, procedures, and training programs tailored to support the delivery of high-quality care at Neighborhood.
• Maintains the Compliance and Ethics Hotline, responds to incident reports of all kinds, including potential fraud, waste, and abuse (FWA), initiates necessary investigations, and ensures timely resolutions.
• Contributes insights and feedback on the performance of the compliance program based on their observations.
• Reviews the exclusion and preclusion screening data to ensure compliance with federal healthcare program requirements as needed.
• Optimizes the use of the Compliance departments software
• Completes compliance and risk related education to enhance skills.

EDUCATION/EXPERIENCE

• Bachelor’s degree required; risk or quality related field, healthcare administration, public health, Legal or similar field preferred.
• Two years of healthcare risk, quality, compliance or operations experience required; healthcare compliance experience within California preferred.
• Clinical/direct patient care experience preferred
• Experience with managing incidents, conducting risk assessments, audits, and data analysis to ensure compliance with healthcare regulations and organizational policies preferred.

ADDITIONAL QUALIFICATIONS (Knowledge, Skills and Abilities)

• Excellent verbal and written communication skills, including superior composition, typing and proofreading skills
• Strong understanding of office procedures and protocol with an emphasis on good organizational skills and diligence.
• Ability to prioritize multiple tasks.
• Excellent customer service skills
• Ability to spreadsheet software for data analysis and reporting, such as Excel
• Ability to interpret a variety of instructions in written, oral, diagram, or schedule form
• Knowledgeable about and experience with regulatory requirements governing healthcare programs in California, including Medicare and Medicaid regulations preferred
• Knowledgeable about and experience with risk assessment methodologies and auditing processes.
• Ability to demonstrate an initiative-taking approach to compliance management by overseeing and monitoring delegated activities.
• Ability to conduct thorough investigations and gather evidence meticulously, displaying strong analytical and critical thinking skills.
• Ability to promote a culture of safety and compliance within the organization.
• Ability to successfully manage multiple tasks simultaneously.
• Excellent planning and organizational ability.
• Ability to work as part of a team as well as independently.
• Ability to work with highly confidential information in a professional and ethical manner.

Physical Requirements

• Ability to lift/carry 10 lbs/weight
• Ability to stand for extended periods of time

COMPLIANCE (Safety & HIPPA)

•  Follows all safety procedures as outlined in Neighborhood Healthcare’s Illness and Injury Prevention Plan (IIPP) and report any injuries and/or unsafe conditions immediately
•  Maintains current knowledge of policies and procedures as they relate to safe work practices
•  Follows all safety procedures and report unsafe conditions
•  Uses appropriate body mechanics to ensure an injury free environment
•  Familiarity with location of nearest fire extinguisher and emergency exits
•  Follows all infection control procedures including blood-borne pathogen protocols
•  Maintains privacy of all patients, employee and volunteer information and access such information only on a need-to-know basis for business purposes
•  Complies with all regulations regarding corporate integrity and security obligations
•  Reports all behavior and/or activity that are unethical, fraudulent, or unlawful

Neighborhood Healthcare offers a generous benefit plan that includes:  Partially company paid Medical, Dental, and Vision Plans. Two plus weeks of vacation, Nine Holidays including two Floating Holidays of your choosing, Sick/Personal time, Volunteer Time Off (VTO), 403b Retirement plan (similar to a 401k), optional Health and Wellness events, and much more! 

Pay Range: $73,500- $104,400 annually, depending on experience and additional qualifications.

Compensation Disclosure:The posted salary range reflects the designated pay grade for this position. While this range represents the broader classification of the role, actual compensation will be based on several factors, including but not limited to: the candidate’s overall knowledge, skills, and experience, market data and industry benchmarks, internal equity within the organization, Budgetary considerations and organizational needs. As a result, placement within the range is not guaranteed, and the full pay grade range may not be utilized.