Harris Health System

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Chief Compliance Officer (CHC)

at Harris Health System

Posted: 9/4/2018
Job Status: Full Time
Job Reference #: 143576
Keywords:

Job Description

About Us

Community Health Choice, Inc. (Community) is a non-profit Health Maintenance Organization (HMO) licensed by the Texas Department of Insurance. Through its network of more than 10,000 providers and 70 hospitals, Community serves over 260,000 Members with the following programs:

• Medicaid State of Texas Access Reform (STAR) program for low-income children and pregnant women

• Children’s Health Insurance Program (CHIP) for the children of low-income parents, which includes CHIP Perinatal benefits for unborn children of pregnant women who do not qualify for Medicaid STAR

• Health Insurance Marketplace Plans that offer individual health coverage that includes preventive care, emergency services, prescription drugs, and hospitalization available to all, regardless of pre-existing conditions.

Improving Members' experiences is at the heart of every Community position. We strive every day to make sure that our Members have access to the high-quality health care they need and deserve.

Community is accredited by URAC for its health plan operations. We offer care management programs for asthma, diabetes, and high-risk pregnancy. An affiliate of the Harris Health System (Harris Health), Community is financially self-sufficient and receives no financial support from Harris Health or from Harris County taxpayers.

Job Profile

Reporting to the Chief Executive Officer, the Chief Compliance Officer is responsible for Community Health Choice, Inc. compliance with all laws, rules and regulations from the Texas Health and Human Services Commission (HHSC), Texas Department of Insurance (TDI), or any other State or federal regulatory agency as they relate to Community products. Leads Community's Corporate Compliance Committee. Responsible for Community's Special Investigative Unit, which identifies and addresses potential waste, fraud and abuse. Represents Community at HHSC, TDI, and other meetings as needed and responsible for communicating information back to Community Staff. Serves as HIPAA Privacy Officer and oversees Community HIPAA Privacy Compliance. Oversees Community's record retention requirements. Responsible for Community's certifications, licensures and accreditations. Monitors corporate risk and manages risks strategically, makes assessments, directs mitigation and leads proactively inter-departmentally to ensure that Community is aware and protected from unnecessary risk.

QUALIFICATIONS:

  • BA/BS.
  • Risk Management and/or Compliance Training/Certification(s) strongly preferred, or alternatively, commitment to and ability to achieve certification within 18 months of employment.
  • Five years in the healthcare compliance and risk management arena; reimbursement and coding experience strongly preferred; familiarity with HHSC (Medicaid; CHIP, etc) and TDI compliance regulations and requirements are required.
  • Three years supervisory experience


OTHER SKILLS:

  • Above Average Verbal communication /Heavy Public Contact/Public Speaking
  • Above average written communication skills
  • Writing /Composing/ Correspondence /Reports
  • Analytical
  • Mathematics
  • Medical Terms
  • Research
  • Statistical

Other Requirements:

  • Knowledge of Medicaid regulations and compliance requirements.
  • Familiarity with HIPAA regulations.
  • Ability to organize task and work independently as well as lead a team and collaborate within and outside of Community.
  • Strong attention to detail and deadlines.
  • Team leader abilities to encourage interdepartmental cooperation and interest.
  • Demonstrate familiarity with physician and hospital coding and billing.

EMPLOYEES SUPERVISED:

  • Clerical
  • Technical/Professional (NE)
  • Professional (Exempt)
Benefits and EEOC

Community employees’ benefits are provided by Harris Health. These benefits are designed to provide you with flexibility and choices in meeting your specific needs.

Community is an Equal Opportunity Employer.

Job Category

All Jobs

Application Instructions

Please click on the link below to apply for this position. A new window will open and direct you to apply at our corporate careers page. We look forward to hearing from you!