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Title

Compliance Specialist 

Position Compliance Specialist  
Category Compliance  
Location North Branch - Ashwaubenon  
Number of Openings 1  
Exempt/Non-Exempt Exempt  
Full-Time/Part-Time Full-Time  
Req Number COM-17-00003  
About the Organization Lakeland Care offers the Family Care Program in the following counties: Fond du Lac, Manitowoc, Winnebago, Calumet, Outagamie, Waupaca, Kewaunee, Oconto, Brown, Door, Shawano, Marinette, Menominee, Florence, Forest, Langlade, Lincoln, Marathon, Oneida, Portage, Vilas and Wood.

Our mission is to: Enrich individuals' lives by honoring their values through high quality, cost effective care and supports. Lakeland Care focuses on individuals' choice, quality care and services, increased access, cost-efficiency and integrated care.

 
Description

Under the general supervision of the Compliance Director, this position is responsible for operational support duties of the Compliance Department within Lakeland Care, Inc. (LCI). This position assists in maintaining LCI’s compliance programs to ensure conformity and adherence with all applicable state, federal and local contracts, laws and regulations. The Compliance Specialist helps in the coordination and support of compliance audits and examinations in conjunction with the Compliance Auditor and provides training to personnel on LCI’s compliance policies and procedures. Performs a variety of routine daily tasks; reviews reports, prepares correspondence; and participates in special department projects. This position supports LCI’s Program Integrity (PI), Civil Rights and HIPAA functions.

Principal Duties and Responsibilities:

The following duties are typical for this position. These are not to be construed as exclusive or all-inclusive. Other duties may be required or assigned.

  • Promote a strong code of ethics and integrity within LCI’s operations.

  • Engage in efforts associated with the preparation of regulatory documents or submissions. Participate in internal or external audits in conjunction with Compliance Auditor.

  • Member of LCI’s Civil Rights Compliance Review Committee, Program Integrity (PI) Committee, and HIPAA Committee and assist with all committee activities and work product.

  • Responsible for investigating, tracking and reporting all PI incidents. May act as LCI’s liaison to external parties for PI-related matters as requested.

  • Maintain and assist with development of all LCI PI, HIPAA, and Civil Rights related documents including the policy and procedures, work plan, and reports.
  • Review compliance with the LCI’s Family Care contract with the Department of Health Services.

  • Interpret regulatory rules or rule changes and ensure that they are communicated through LCI policies and procedures.

  • Coordinate and perform internal investigations and interviews in a confidential manner as directed.

  • Communicate with regulatory agencies regarding pre-submission strategies, potential regulatory pathways, compliance test requirements, or clarification and follow-up of submissions under review.

  • Develop or conduct employee regulatory training, including HIPAA and PI.

  • Assist with projects or other duties which may cross any or all divisions within Lakeland Care.
 
Position Requirements

  • Bachelor’s Degree in Business, Finance or a related field preferred; or equivalent combination of formal education and experience.

  • Healthcare compliance experience preferred; or equivalent combination of healthcare experience and education.

  • Thorough understanding of ethics, regulations, and laws.

  • Knowledge of compliance ethics/control and forensic financial investigation preferred.

  • Knowledge of HIPAA, state and federal guidelines on privacy, transactions and security.

  • Solid understanding of Civil Rights regulations and ability to comply.

  • Knowledge of Program Integrity requirements specific to Medicaid fraud, waste, and abuse.

  • Meticulous and detail oriented mindset.

  • Excellent communication and leadership skills are needed to be able to interact locally and statewide on necessary committees and bring forth ideas and solutions.

  • Current WI driver’s license, acceptable driving record and proof of adequate insurance required.

In evaluating candidates for this position, Lakeland Care may consider a combination of education, training and experience which provides the necessary knowledge, skills and abilities to perform the duties of the position.

 
EOE Statement We are an equal employment opportunity employer functioning under an Affirmative Action Plan. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, national origin, disability status, protected veteran status or any other characteristic protected by law.  

This position is currently not accepting applications.

To search for an open position, please go to http://LakelandCare.appone.com



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