Senior Compliance Specialist - Stony Brook CPMP Compliance
Location: St. James, NY - This position is eligible for our hybrid work model. This is subject to change at the discretion of management.
Days/Hours: Monday - Friday; 8:00am - 4:30pm
SUMMARY: The SB Clinical Practice Management Plan, Inc. (CPMP) Senior Compliance Medical Specialist supports the functions of the Compliance Program for CPMP and its University Faculty Practice Corporations to be compliant with Federal and State guidelines in the prevention of fraud, waste, and abuse. The Senior Compliance Medical Specialist will participate and provide duties such as but not limited to conducting auditing and monitoring; providing training and education; assessing compliance with policies, procedures, and regulations; identifying and recommending strategies for process improvements; assessing complex compliance risk-areas to provide input to the annual work plan; participating in investigations; and preparing written reports. The Senior Compliance Medical Specialist performs auditing and monitoring of clinical documentation, analyzing medical records, and assessing the accuracy of ICD-10-CM diagnosis code and CPT assignments; and determining compliance with Federal and State regulations and guidelines. These audits and other projects are identified considering risks identified in State and Federal work plans, industry communications, fraud alerts, regulatory agencies, data mining using software applications, or per management’s request.
Responsibilities and Duties
Requirements & Qualifications:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to communicate with patients, staff and medical providers. The employee must be able to exchange accurate information in these situations. This position is largely sedentary and requires the employee to remain stationary for a majority of the day. Any additional physical demands will be outlined and provided by management. The responsibilities and tasks outlined in this job description are not exhaustive and may change as determined by the needs of CPMP.
In accordance with the New York State Department of Health (DOH) order that all hospitals and nursing homes “continuously require all personnel to be fully vaccinated against COVID-19,” Candidates who are not already vaccinated must obtain the first dose of the vaccine within three (3) calendar days of acceptance of conditional job offer and must obtain any subsequent doses in accordance with the vaccine protocol. The order also includes those who may be affiliated with or interact with employees of a hospital or nursing home. The order allows for limited medical exemptions with reasonable accommodations, consistent with applicable law.
CPMP provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, creed, gender, national origin, age, disability, marital or veteran status, sexual orientation, gender identity or expression, or any other legally protected status. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall and transfer, leaves of absence, compensation and training.
CPMP expressly prohibits any form of workplace harassment based on race, color, religion, creed, gender, national origin, age, disability, marital or veteran status, sexual orientation, gender identity, or any other legally protected status. Improper interference with the ability of CPMP’s employees to perform their job duties may result in discipline up to and including discharge.