Revenue Compliance and Privacy Manager

OrthoNebraska is seeking a Revenue Compliance and Privacy Manager to join our team. Teamwork is paramount as we are dedicated to Always True in promoting trust, respect, understanding and engagement with all team members. Our top priorities are focusing on patient safety as well as patient experience. If this sounds like the type of team and environment, you want to be a part of apply today!

This on-site leadership role is dedicated to safeguarding patient confidentiality, ensuring compliance with HIPAA and other privacy regulations, and overseeing the organization's revenue cycle compliance program along with playing a key role in the organization's corporate compliance program. The position is critical in managing risk, identifying opportunities for improvement, and ensuring adherence to state and federal regulations.

As a management-level position, this role is responsible for leading and overseeing privacy and compliance initiatives, including supervising direct reports. The Manager is instrumental in coordinating cross-departmental projects, fostering compliant vendor relationships, and developing proactive strategies to mitigate risks and enhance organizational performance. By collaborating with relevant committees and officers, the Manager ensures that the organization's privacy and compliance programs are fully aligned with regulatory requirements and strategic goals.

Position details

Position requirements

• Education: Graduate from an accredited school/college with a bachelor's degree in health information management or another related field required.
• Certification: CHC, CHPC, CIPP, RHIA, or similar privacy or compliance related certifications required.
• Experience: Minimum 10+ years of leadership experience with 7+ years in healthcare management required. Minimum of 5 years in healthcare privacy or compliance investigations required.

Essential Job Functions

Privacy Responsibilities

· Lead the organization's privacy program as the Privacy Officer in conjunction with the Privacy Committee, ensuring compliance with HIPAA and other privacy regulations.

· Develop and execute a comprehensive privacy audit plan, including email security audits, chart access audits, and ad hoc audits as needed.

· Investigate privacy incidents and complaints thoroughly, including interviews, access audits, and log reviews, ensuring timely resolution and accurate documentation.

· Serve as the primary contact for privacy-related concerns, collaborating with patients, families, and staff to address issues.

· Apply in-depth knowledge of HIPAA Privacy Rules and state/federal regulations to guide incident resolution.

· Collaborate with IT Cybersecurity and Information Security Officers to address privacy events with security implications.

· Manage and maintain accurate records of investigations in the organization's privacy repository.

· Partner with Human Resources on corrective actions and sanctions related to noncompliance, as needed.

· Prepare and submit breach notifications and substantiated complaint documents as the Privacy Officer.

· Conduct breach risk assessments, assist with patient notification letters, and support compliance reporting.

· Develop educational content and deliver privacy-related training programs and monitor third-party compliance with privacy standards.

· Stay informed of evolving privacy standards and healthcare regulations to ensure organizational readiness.

Compliance Responsibilities

· Lead the development and execution of the organization's revenue compliance program, ensuring alignment with federal and state regulations and payer requirements.

· Leads compliance committee initiatives in coordination with cross departmental leadership, preparing and presenting performance reports to support the compliance oversight and decision-making.

· Research and assess compliance risks and regulatory differences related to organizational growth, including mergers and acquisitions, and communicate findings effectively.

· Oversee and manage the DME revenue cycle compliance program, ensuring documentation, billing, and reporting meet regulatory standards.

· Drive cross-functional projects to assess and address compliance risks, improve processes, and implement proactive solutions in partnership with the Compliance Officer and Compliance Committee while owning the monitoring and mitigation plans to minimize risk.

· Design and implement compliance training programs for staff, fostering awareness and accountability across the organization.

· Evaluate vendor and contractor compliance with contracts, BAAs, and regulatory requirements, ensuring corrective actions when necessary.

· Create and communicate compliance strategies, risks, and mitigation efforts to leadership through concise reports, presentations, and actionable insights for leadership decision-making.

· Champion a culture of compliance and professionalism, aligning departmental efforts with organizational goals and regulatory standards.

Physical requirements:

• This position is classified as Light Work in the Dictionary of Occupational Titles, requiring the exertion of up to 20 pounds of force frequently, and/or a negligible amount of force constantly (66% of the time) to move objects. Physical Demand requirements are in excess of those for sedentary work.