Compliance Specialist

ChristianaCare is one of the country's most dynamic healthcare organizations, centered on improving health outcomes, making high-quality care more accessible, and lowering healthcare costs. ChristianaCare includes an extensive network of outpatient services, home health care, urgent care centers, three hospitals (1,299 beds), a free-standing emergency department, a Level I trauma center and a Level III neonatal intensive care unit, a comprehensive stroke center and regional centers of excellence in heart and vascular care, cancer care, and women's health. It also includes the pioneering Gene Editing Institute and was rated by IDG Computerworld as one of the nation's Best Places to Work in IT. ChristianaCare is a nonprofit teaching health system with more than 260 residents and fellows. Continually ranked by U.S. News & World Report as the Best Hospital. With the unique CareVio data-powered care coordination service and a focus on population health and value-based care, ChristianaCare is shaping the future of health care.

ChristianaCare Offers:

• Full Medical, Dental, Vision, Life Insurance, etc.
• Two retirement planning offerings, including 403(b) with company contributions
• Generous paid time off with annual roll-over and opportunities to cash out
• 12-week paid parental leave
• Incredible Work/Life benefits including annual membership to care.com, access to backup care services for dependents through Care@Work, retirement planning services, financial coaching, fitness and wellness reimbursement, and great discounts through several vendors for hotels, rental cars, theme parks, shows, sporting events, movie tickets and much more!

About This Position:

The General Compliance Specialist supports the Compliance Department with the execution of compliance projects and helps maintain organizational compliance with federal and state healthcare laws and regulations. The General Compliance Specialist supports the ChristianaCare Health System’s Compliance Plan through assigned compliance activities to ensure effective documentation. Through communication and training activities, they provide information or clarification on operational compliance inquiries, documentation standards, guidelines, and regulatory requirements. The Compliance Specialist responds to alleged violations of rules, regulations, policies, procedures, and standards of care by evaluating or recommending the initiation of root cause analyses and performing all steps necessary to restore compliance, including tracking corrective actions and ensuring ongoing oversight in response to perceived or identified opportunities to improve.

The General Compliance Specialist supports the Compliance Department in implementing and maintaining ChristianaCare’s Compliance Program and promoting adherence to applicable federal and state laws, regulations, and organizational policies, including the Code of Conduct. The Specialist assists with compliance initiatives that support program effectiveness and regulatory compliance. Through education, communication, and guidance, the Specialist helps reinforce compliance standards by responding to compliance inquiries and providing clarification regarding policies, documentation requirements, and regulatory expectations. The Specialist also supports the identification, investigation, and resolution of potential compliance concerns by conducting assessments, facilitating or recommending root cause analyses, tracking corrective action plans, and monitoring follow-up activities to ensure sustained compliance and continuous improvement.

Principal Duties and Responsibilities:

· Works to ensure timely resolution of privacy issues and facilitates communication of privacy-related matters.

· Supports the day-to-day operations of the Compliance Program under the direction of the Director of Compliance (Auditing & Monitoring).

· Assists in developing, implementing and reviewing compliance and privacy policies and procedures, as needed.

· Keeps abreast of current privacy and compliance regulations and regulatory changes to conduct accurate audits and reviews.

· Performs assigned work plan schedule reviews and projects, as outlined in the Compliance Department Workplan.

· Responds to alleged violations of rules, regulations, policies, procedures, and standards of care by evaluating or recommending the initiation of root cause analyses and performing all steps necessary to restore compliance, including tracking corrective actions in response to perceived or identified opportunities to improve.

· Supports efforts to communicate compliance initiatives, including written materials and training programs, designed to promote awareness, and understanding of compliance issues, the Organizational Code of Conduct, and related law, regulations and government directives or guidance.

· Routinely performs regulatory research and provides written guidance to business partners on regulatory changes.

· Conducts privacy audits and focused reviews to ensure compliance with government and payor guidelines.

· Assists with maintaining regular and consistent governance-level reporting and metrics for the Compliance department, including but not limited to dashboards, board reporting, weekly, monthly, and annual compliance & ethics reporting.

· Assists with reviewing internal and external inquiries regarding professional and hospital/clinical billing compliance matters, including government and third-party payor requests.

· Maintains required credentials; assume responsibility for ongoing professional growth; exhibit a high level of professionalism; act as role model for staff and others in the organization.

· Maintains confidentiality of patient/members and staff information.

· Performs assigned work safely, adhering to established departmental safety rules and practices; reports to supervisor, in a timely manner, any unsafe activities, conditions, hazards, or safety violations that may cause injury to oneself, other employees, patients and visitors.

· Performs other related duties as required.

Education and Experience Requirements:

· Bachelor’s degree required.

· Certification in Healthcare Compliance (CHC) and/or Certification in Healthcare Privacy Compliance (CHPC) preferred.

· Minimum of three (3) to five (5) years of experience in a healthcare organization, prior privacy operations, privacy auditing, administrative, or consultative experience preferred.

Christiana Care Health System is an equal opportunity employer, firmly committed to prohibiting discrimination, whose staff is reflective of its community, and considers qualified applicants for open positions without regard to race, color, sex, religion, national origin, sexual orientation, genetic information, gender identity or expression, age, veteran status, disability, pregnancy, citizenship status, or any other characteristic protected under applicable federal, state, or local law.

Post End Date

EEO Posting Statement

ChristianaCare offers a competitive suite of employee benefits to maximize the wellness of you and your family, including health insurance, paid time off, retirement, an employee assistance program. To learn more about our benefits for eligible positions visit https://careers.christianacare.org/benefits-compensation/

About Us

Christiana Hospital, Newark, Delaware.

This 1,007-bed, 1.3-million-square-foot modern facility provides a level of care only available in large-scale teaching hospitals. Christiana Hospital includes Delaware's only Level-I Trauma center (as verified by the American College of Surgeons), which is prepared to handle the most extreme medical emergencies. In fact, it is the only Level-I Trauma center on the East Coast corridor between Baltimore and Philadelphia. Christiana Hospital has also been nationally recognized in U.S. News & World Report's Best Regional Hospitals rankings as #1 in Delaware and #3 in the Philadelphia metro area, plus High Performing in 9 Adult Procedures/Conditions

Christiana Care Health System Website