Compliance Officer

Company: Sacred Circle
Location: Salt Lake City
Posted on: April 1, 2025

Job Description:

As an entity of the Confederated Tribes of the Goshute Reservation, we, at Sacred Circle Healthcare, preserve the Goshute heritage of protecting and caring for family and extend the tradition to all marginalized and underserved populations in our area. We refuse to let access, ethnicity, or socioeconomic status restrict someone from receiving complete healthcare. Interested in joining our team? We are looking for people who are genuine, kind, ambitious, positive, and helpful - exceptional people building on a celebrated heritage who are passionate about delivering uncompromising care - people who make a difference every day no matter what their role or position. If you are looking for a job where the work you do impacts lives for the better every day, you are in the right place!Sacred Circle Healthcare is seeking a full-time, Compliance Officer, in Salt Lake City, Utah, to join our Executive Team.Job SummaryOverview: The Compliance Officer's objective is to ensure that Sacred Circle Healthcare (SCHC) establishes and maintains an effective, best practices, quality, compliance program. The Compliance Officer is a member of the executive leadership team and shall seek to prevent and detect violations of law and other misconduct, promote ethical conduct, and foster a culture that is committed to compliance with the law. The Compliance Officer shall ensure faithful implementation of the program as directed by the CTGR Health Department Board of Directors (Board). The program will include standards, procedures, and internal controls reasonably capable of preventing, reducing, and detecting criminal conduct. It will also consist of an appropriate information and reporting system so that the Board and senior management may exercise timely and informed judgments concerning the SCHC's compliance with the law. The Compliance Officer is responsible for ensuring compliance with all regulations, including but not limited to the regulations of these agencies: OIG, OSHA, CLIA, AAAHC, State, and CMS. The Compliance Officer is also responsible for, including but not limited to; ensuring compliance with the Anti-Kickback Statute, Stark Law, Affordable Care Act, and the False Claims Act.Reports to:The Compliance Officer has unrestricted, independent access to the Board and the CTGR Business Council. The Compliance Officer reports to the Board and the CTGR Business Council and administratively regarding the day-to-day operations to the Executive Officer. At a minimum, the Compliance Officer shall provide quarterly reports regarding all relevant compliance program activities to the: - Board; - CTGR Business Council; - Executive Officer and executive leadership team.The Compliance Officer shall, in their sole discretion, if there is reason to believe that SCHC is not in compliance, report directly to the OIG or other governmental agency with or without approval of or consultation with legal counsel. The Compliance Officer shall have unlimited access to facilities, records, and personnel, all senior management meetings, all or any of the Directors of the Board, and internal and external Legal resources. The Compliance Officer is not subordinate to and does not report to legal counsel. The Compliance Officer does not provide legal counsel or advice.Department:ExecutiveBusiness Unit:Quality and CompliancePatient Care:NoWorker Status:Full-time, benefits eligibleHours Per Week:40Location:Salt Lake Main ClinicSupervisor Responsibilities:Yes, Quality Assurance Manager, Compliance Specialist, Data Analyst (Internal Auditor)Work Schedule:To Be Determined with the availability of 8:00 am - 6:00 pm Monday through Friday. Evening and weekend work may be required as needed. The successful candidate:

• Implements and administers the compliance activities as described in the Tribal Health Program Integrity Agreement (THPIA)
• Exercises oversight responsibility for the compliance program. Develops new policies, processes, and procedures for compliance as needed.
• Ensures that appropriate standards, practices, and internal controls, including a code of conduct, are adopted, published, and explained to employees and agents.
• Develops and coordinates compliance education and training. Ensures that an effective system exists for communicating the compliance program's standards and guidance in the compliance risk areas, including training and other communications media, to employees, officers, members of the Board, and, as appropriate, agents.
• Ensures that each compliance risk area is identified and appropriately addressed through the compliance program and that risk assessment occurs periodically. Delegates to designated business unit managers responsibility for oversight of the compliance program in their business units. The Compliance Officer is still responsible for overseeing compliance in each of those business units.
• Establishes and convenes such committees and groups, including interdepartmental committees, as necessary to implement the quality and compliance program.
• Ensures that there is a system in place for appropriate monitoring, auditing, and other measurements of a) the program's effectiveness; and b) SCHC's compliance with law and ethical standards.
• Acts as an advocate and champion of the compliance program among senior managers and provides advice on compliance and ethics matters. Assist the senior managers in discharging their duty to ensure that SCHC has an effective compliance program.
• Ensures that there is an effective system in place for employees and other agents to raise questions and obtain advice regarding compliance and integrity, and to report misconduct without fear of retaliation, and with appropriate follow-up.
• Ensures that reports and other indications of possible misconduct are appropriately and professionally investigated, and that appropriate corrective action is taken, including enhancements to the compliance program, disclosure to the government if warranted.
• Ensures that there is an effective and consistent system of discipline to address misconduct, and an evaluation and incentive system that promotes legal and ethical conduct and that any findings of misconduct and of weaknesses in the compliance program are responded to promptly and effectively.
• Has access to advice from legal counsel in implementing the compliance and integrity program and in diligently monitoring current trends and developments to identify emerging new risks.
• Ensures coordination with other departments including quality, grants, legal, internal audit, project management, human resources, and information technologies to ensure effective implementation of the compliance program.
• Maintains and communicates knowledge of payer claim submission guidelines and coverage requirements through routine education of applicable employees on such guidelines and requirements.
• Coordinates with other departments involved with external liaison functions, to ensure an understanding by outside audiences of SCHC's commitment to compliance.
• Serves as a resource for the quality department through the Quality Assurance Manager.
• Ensures that the compliance program appropriately addresses acquisitions, joint ventures, agents, and other third parties.
• Reads, understands, and adheres to all Sacred Circle Health Care Policies and Procedures.
• Practices and adheres to the Code of Conduct and Mission and Values Statements.
• Other Duties as Assigned.Minimum RequirementsEDUCATION: Master's degree in a related field, and 5 or more years' equivalent healthcare experience.EXPERIENCE:
  • Eight (8) or more years of progressive healthcare management experience required.
  • Significant experience in the health care industry, with specific ethics/compliance program experience or legal experience.
  • Three to Five (3-5) years leading a team of direct-reports or equivalent.
  • Experience in risk management. Preferred Requirements:EXPERIENCE: Five (5) or more years' direct experience managing compliance program activities.Three (3) or more years' direct experience in ambulatory care compliance or quality improvement.Other:Experience working with the Native American community.Experience working in a healthcare setting. Knowledge, Skills, and Abilities
    • Proven ability to work with all levels of management.
    • Strong problem-solving skills.
    • Knowledge of legal requirements and controls
    • Familiarity with industry practices and professional standards
    • Familiarity with Medicare and Medicaid programs and state insurance law preferred.
    • Excellent written, oral, and presentation communication skills.
    • Knowledge of governmental and accreditation reporting programs.
    • Knowledge of organizational policies, procedures, systems, and objectives.
    • Knowledge of clinic office procedures.
    • Ability to use computer systems and applications.
    • Familiarity with medical practices terminology.
    • Ability to use proper grammar, spelling, punctuation, and sentence structure to answer correspondence and prepare reports.
    • Ability to plan and organize. Oversees workflow.
    • Ability to evaluate the effectiveness of existing methods and procedures.
    • Ability to communicate effectively with patients, clinical and administrative staff, and the public.
    • Ability to interpret, adapt and apply guidelines and policies and procedures.
    • Ability to react calmly and effectively in emergency situations.
    • Ability to work under minimal supervision but maintain a high degree of communication of current work activity with supervisors.
    • Maintains strict confidentiality.Additional Information - Join us as we are Redefining Compassionate Healthcare, together!As group of 4 healthcare clinics, diversity drives our identity. We are proud of our Native American heritage. Whether you are seeking your first job, transitioning back into the workforce, looking to start your career, or grow an existing one, Sacred Circle Healthcare walks with you. We need you for what you can do. We strive for a mix of benefits to help you combine great work with a great life.
      • Competitive pay
      • Healthcare coverage for you and your family
      • Generous PTO, paid holidays and floating holidays to celebrate what is important to you (prorated for part-time employees)
      • Retirement matching to invest in your future
      • Colleagues that are unparalleled
      • A culture that is second to none Sacred Circle Healthcare/Confederated Tribes of the Goshute Reservation gives preference to qualified American Indian/Alaskan Native Applicants
        
        Compensation details: 180000-190000 Yearly Salary
        
        
        
        PI89bf2d98c793-37248-37255121

Keywords: Sacred Circle, Salt Lake City , Compliance Officer, Other , Salt Lake City, Utah