Revenue Specialist I, ROPS
DaVita Kidney Care
Compliance Research and Policy Analyst
ADP
full-time
Posted on:
Origin: • 🇺🇸 United States
Visit company websiteJob Level
Mid-LevelSenior
About the role
- Conducts in-depth analysis of federal, state, and local laws, regulations, and guidance pertaining to third party payors, HIPAA, managed care, and broader healthcare delivery systems
- Translates complex regulatory requirements into clear, concise, and actionable internal policies and procedures
- Drafts and revises compliance-related policies and procedures and maintains policy version control
- Tracks and analyzes legislative and regulatory changes relevant to the organization's operations and strategic objectives
- Assists in comprehensive compliance risk assessments and development of mitigation strategies
- Contributes to preparation of internal and external compliance reports for executive leadership and the Board of Managers
- Serves as a policy advisor to internal departments on complex compliance-related issues and regulatory interpretations
- Participates in cross-functional teams to support implementation of compliance initiatives
- Develops summaries, briefs, and presentations on complex policy and regulatory topics for staff, leadership, and community stakeholders
- Assists in development of compliance training materials related to policy updates and regulatory trends
- Performs other duties as assigned
Requirements
- Bachelor’s degree in Public Health, Public Policy, Healthcare Administration, Political Science, or a related field
- Minimum Experience: 4 years Experience in policy research, compliance, or a healthcare regulatory role
- Deep understanding of healthcare regulations and public health policy, including HIPAA, Medicaid, CMS regulations, OIG guidance, and Texas state health laws
- Working knowledge of the legislative and regulatory process at both state and federal levels
- Ability to assess and support the rapid development of health care services
- Ability to effectively understand basic legal considerations related to service delivery and the practice of medicine
- Ability to apply critical thinking to generate and assess potential solutions and to anticipate client needs in advance
- Ability to manage competing objectives in an ambiguous, fast-moving environment to achieve results
- Knowledge of data, measurement concepts, measurement tools and systems used to monitor and report clinical quality metrics, healthcare safety and other healthcare outcomes
- Ensure compliance with data confidentiality and security laws, regulations, policies and standard operating procedures
- Exceptional interpersonal skills with ability to interface effectively internally and externally with a wide range of people including colleagues, physicians, health care executives, community organizations and assigned staff
- Strong writing and editing skills for technical, legal, and policy documents
- Strong attention to detail and accuracy
- Ability to communicate complex ideas clearly and effectively through both writing and speaking
- Demonstrated ability to perform complex operations in Microsoft Office Suite
- Supports and models the vision, mission and values of Central Health
- Responds in timely manner to the needs and concerns of colleagues, providers, staff and other stakeholders
- Adheres to all local, state and federal laws and regulations and Central Health policies
