Compliance and Privacy Manager - JD

The Compliance and Privacy Manager oversees, in pertinent part, the following compliance risk areas: (i) general compliance and compliance program effectiveness; (ii) fraud, waste and abuse and Deficit Reduction Act of 2005 workforce member and contractor compliance; (iii) patient and employee confidentiality, organizational privacy, information governance, and data risk classification; (iv) accountable care organization compliance; (v) Medicare C & D/Medicare Advantage compliance program requirements; (vi) Federal healthcare program compliance; and (vii) other assigned risk areas identified through organizational experience, risk identification activities, or regulatory mandates. + The Manager will support the Director of Corporate Compliance to ensure implementation of appropriate policies and procedures, support compliance training, conduct investigations. + Perform compliance program effectiveness reviews based on the seven (7) elements of an effective compliance program as set forth in: (i) relevant U.S. Department of Health and Human Services compliance program guidance; (ii) U.S. Sentencing Commission Guidelines Manual; (iii) U.S. Department of Justice, Criminal Division, compliance program guidance; (iv) CMS Conditions of Participation; (v) Medicare Shared Savings Program Accountable Care Organization Compliance guidance and regulatory requirements; and (vi) Medicare C & D/Medicare Advantage compliance program requirements. + Maintain a system of reporting and ensure the integrity of all compliance investigations, direct and coordinate internal audits, and monitor HIPAA/Patient Privacy compliance. + The Manager ensures that the Compliance Program effectively promotes prevention, detection, and resolution of instances of improper conduct to ensure conformity to state or federal laws, regulatory requirements, hospital policies, patient privacy, IT Security or the standards of conduct. + The Manager will be responsible for following up on reported incidents of non-compliance, conduct and or coordinate internal investigations and prepare reports on the incidents and investigation findings. + The Manager will be responsible for assessing compliance of the organization's policies and assist in updating or developing new policies. + The Manager will assist in evaluating areas of potential billing, Stark, Anti-kickback compliance or patient privacy risk and collaborate with other managers within the organization to work with management to implement solutions to eliminate potential risks. + Manage and investigate compliance questions, complaints, and reported incidents in collaboration with management, legal and human resources, as needed. + Responsible for Compliance Program data analytics to develop reports for monitoring and auditing, case management and federal reporting. + Responsible for developing organizational wide compliance communication plan, communications, and training programs. + Coordinate HIPAA Security compliance activities with the AH HIPAA Security Officer/Information Security Officer. + Investigate HIPAA-related complaints and draft corresponding reports. + Draft responses to HIPAA-related regulatory inquiries. + Review business associate agreements, data use agreements, and limited data set agreements and ensure said agreements are acceptable as to compliance form and meet standard form internal requirements. + Conduct risk assessments and audits pertaining to assigned compliance risk areas. + Conduct compliance and privacy training and education. + Prepare PowerPoints and present educational or compliance-related topics to AH constituents. + Draft compliance and HIPAA-related policies and procedures, as well as policies and procedures related to other assigned risk areas. + Assist in conflict-of-interest reviews, evaluations, and determinations. + Assist in conflict-of-interest endorsement requests reviews. Qualifications: u2022 Education: A Juris Doctor degree from an ABA accredited law school and admission to the bar to practice law in one of the 50 States (or Washington, D.C.) of the U.S. is required. The holding of a Masteru2019s Degree in public health, healthcare, accounting, allied health, clinical-related studies, compliance, audit, computer science, finance, education, law, privacy, information security, information governance, or another field related to the responsibilities of the position at hand, is a plus. u2022 Certifications: Candidates who hold the u201cCCEPu201d or u201cCHCu201d designation from the Compliance Certification Board are strongly preferred. Any successful candidate who does not hold the u201cCHCu201d designation at the time of appointment will be required to obtain the same within 12 months of appointment. A successful candidate must obtain either the u201cCISAu201d, u201cCRISCu201d, or u201cAAIAu201d designation from ISACA within eighteen (18) months of employment. Experience: u2022 Five years minimum of health care compliance experience, health care administration, legal, fraud, waste, and abuse; internal audit, organizational compliance, regulatory affairs or a filed related to the responsibilities of the position at hand, is preferred. u2022 Experience in conducting compliance investigations, legal internal investigations, or similar investigations is required; u2022 Managerial experience in a healthcare organization or related setting is preferred. Technical: u2022 Proficiency in Microsoft Word, Excel, PowerPoint. Other Required Skills u2022 Demonstrated current knowledge of business ethics, legal and compliance risks. u2022 Advanced and highly developed communication and influencing skills. u2022 Excellent writing skills. #LI-AW1 At Atlantic Health System, our promise to our communities is; Anyone who enters one of our facilities, will receive the highest quality care delivered at the right time, at the right place, and at the right cost. This commitment is also echoed in the respect, development and opportunities we give to our more than 20,000 team members. Headquartered in Morristown, New Jersey, we are one of the leading non-profit health care systems in the nation. Our facilities and sites of care include: + Morristown Medical Center, Morristown, NJ + Overlook Medical Center, Summit, NJ + Newton Medical Center, Newton, NJ + Chilton Medical Center, Pompton Plains, NJ + Hackettstown Medical Center, Hackettstown, NJ + Goryeb Children's Hospital, Morristown, NJ + CentraState Healthcare System, Freehold, NJ + Atlantic Home Care and Hospice + Atlantic Mobile Health + Atlantic Rehabilitation We also have more than 900 community-based healthcare providers affiliated through Atlantic Medical Group. Atlantic Accountable Care Organization is one of the largest ACOs in the nation, and we are a member of AllSpire Health Partners. We have received awards and recognition for the services we have provided to our patients, team members and communities. Below are just a few of our accolades: + 100 Best Companies to Work For u00ae and FORTUNEu00ae magazine for 15 years + Best Places to Work in Healthcare - Modern Healthcare + 150 Top Places to work in Healthcare - Becker's Healthcare + 100 Accountable Care Organizations to Know - Becker's Hospital Review + Best Employers for Workers over 50 - AARP + Gold-Level

Created: 2025-12-05