Hospital Chief Compliance and Privacy Officer
Oversight of an effective corporate compliance and privacy program for two campus 768 bed hospital.
- Implemented Tenet's compliance program as detailed by Corporate Integrity Agreement executed with Tenet and the Office of Inspector General and the organizations Quality and Ethics Charter.
- Advised hospital leadership on issues concerning Federal healthcare program requirements, Billing and Coding, Stark and Anti-Kickback statutes, HIPAA, Quality and Risk Management, EMTALA, Contracts, Human Resources, Medical Staff, and Ethics matters.
- Chaired the Hospital Compliance Committee and assisted in identifying risk areas and developing auditing and monitoring processes related to risks.
- Reporting to Atlanta Medical Center Board and Audit and Compliance Committee.
- Provided corporate compliance training to employees and implement policies, procedures and standards that promote corporate governance and risk reduction.
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Director of HIM and Privacy Officer
- Directly Supervised the Health Information Management Department overseeing 6 FTE's along with Per Diem
- Served on multiple committees (Operations Council, Quality Council, Medical Executive, Corporate HIPAA
- Oversaw and maintained the E-PHI Access Review Coordinator
- Oversight of Release of Information (IOD) & Transcription (AssistMed) Vendor Services.
- Completed a Workflow Overhaul Post EMR Implementation. Put processes in place to eliminate 4 months
- Point person for Post-EMR Implementation Training & Assisting Clinical Staff.
- Served as the Hospital HIPAA Officer handling training, education and investigations on the hospital level.
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Affiliate Privacy Officer
- Managed the daily operations of privacy program at Alta Bates Summit Medical Center.
- Advised management and members of the workforce on privacy related issues.
- Conducted investigation of privacy incidents and ensured timely reporting to government regulatory agencies and patients as well as appropriate disciplinary action and corrective action plans.
- Assisted with planning and implementation of response to large privacy breaches including regulatory response.
- Interfaced with regulatory bodies and law enforcement.
- Provided consultation to leadership, management and workforce to ensure processes and procedures were in compliance with privacy regulations.
- Identified opportunities for process improvement and worked with managers and leadership to ensure adoption.
- Presented privacy training for new employees at affiliate new employee orientation as well as provided department
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Coding Supervisor/privacy Officer
- Managed hospital coding services
- Served as resource for coders and provided additional and/or back up coding services when necessary
- Monitored Medicare publications for documentation and coding requirements
- Ensured coders and physicians are educated on changes in ICD-9-CM, CPT-4, and HCPCS coding changes
- Loaded DRG and APC updates into Meditech and HSS encoder
- Assisted in updating Chargemaster by reviewing CPT-4 and HCPCS changes
- Submitted inpatient and outpatient data to Iowa Hospital Association
- Served as Privacy Officer, including education and training of all facility staff, handling Privacy breaches, obtaining Business Associate Agreements, writing policies, speaking to outside agencies regarding HIPAA
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DIRECTOR of PERFORMANCE IMPROVEMENT & CORPORATE PRIVACY OFFICER
- Manage performance activities of a $100M agency for over 80 diverse programs including CARF and COA accreditation
- Serve as corporate HIPAA officer for agency to maintain log, enforce regulations and approve HIPAA training courses for all staff
- Track, monitor and analyze data related to program outcomes, occupancy and incident report for process improvements to policies and systems.
- Advised and revised agency policies for program operations and lead strategic planning committees
- Assist and lead executive identified special projects to identify gaps in program operations
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Deputy Privacy Officer
- Manage ICE's privacy staff in assessing privacy risks in the collection, use, dissemination, and retention of data; review and edit internal and public-facing privacy compliance documentation
- Evaluate the impact of Executive Order 13768 (Jan. 2017) on ICE's mission; identify and resolve privacy concerns in projects and programs; oversee adjudication of Privacy Act amendments and privacy complaints
- Interpreted and applied the "Judicial Redress Act of 2015" to ICE's activities
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Chief Compliance and Privacy Officer
- Successfully managed day-to-day operations of the compliance, auditing, credentialing, fraud, quality, and privacy programs for this Minnesota Medicare Advantage health plan. Active participant in executive leadership and strategic planning teams. Introduced lean processes to the operational segment of the organization.
- Directed programs and practices to ensure the Board, management and business units were compliance with requirements relating to government healthcare programs, that policies and procedures were followed, and that behavior met the standards of the Code of Conduct.
- Overall responsibility for conducting research, drafting, reviewing and negotiating all provider and vendor contracts, providing legal advice when appropriate and necessary.
- Proven experience with CMS Audit Protocols, risk assessments and annual work plans. Worked very closely with Quality Improvement to improve CAHPS, STARS and HEDIS results, manage utilization rates, provide care coordination and case management, member safety initiatives, and other directives to improve clinical services and business operations.
- Worked closely and developed close working relationships with stakeholders, the community, and regulators, to ensure a better understanding of the organization, our policies, objectives and initiatives.
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Senior Director, Chief Privacy Officer
Lead privacy compliance efforts for Bank/Upromise, responsible for the implementation and oversight of the Privacy Compliance Program (2nd Line) including execution of quarterly/annual risk assessments and mitigation across lines of business (1st Line) partnering with Internal Audit (3rd Line) resulting in increased transparency and reporting to Executive Leadership. Maintain relationships throughout entities enabling assessment/resolution of privacy issues. Key business partners include Legal, InfoSec, LOB, Product Development and Vendor Risk Management.
- Chair Privacy Council authorizing data sharing activities affiliated/unaffiliated third parties), determination of data-governance requirements including tracking/reporting to management.
- SME providing guidance on all matters associated with privacy-by-design, contractual relationships, outsourcing, off-shoring, technology impacts, business initiatives and internal audits/regulatory examinations (FDIC/CFPB).
- Oversee enterprise-wide privacy/cybersecurity incident response program, ensure reporting of issues into system of record, research requirements, partner with committee members ensuring the investigation is conducted and all required notifications are made (customer, law enforcement and regulatory authorities).
- Advise on compliance testing/monitoring and training requirements ensuring appropriate control environment along with development of mitigation strategies and delivery of reporting to management committees.
- Monitor regulatory changes/emerging risk advising of impact/policy requirements to drive enhancement for compliance with laws/regulations, industry best practices. Provide metric reporting for senior management committees.
- Established highly visible role interacting with employees at all levels providing education/guidance on all privacy matters. Enhance Bank’s reputation and visibility through participation with industry organizations and events (IAPP and SCCE), external auditors and regulatory agencies.
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Information Systems Security Officer / Privacy Officer
- Serves as an Information Security Officer with policy knowledge for the FDA Information Security and Privacy program and following the Risk Management Framework (RMF) guidance and incident response policy issues are integrated into FDA operations and business processes.
- Participating in and preparing reports such as FIPS 199 categorization, NIST 800-53 r4 control assessments, System Security Plans (SSP), Privacy Impact Assessments (PIA), drafting Staff Manual Guides, Assessment and Authorization packages (A&A), yearly FISMA reports and other HHS reporting metrics.
- Collaborate on reports of information security and PII breaches involving sensitive information, unauthorized access, administrative account requests, new software requests and advising on next actions with the FDA Security Operations Center (SOC).
- Provide a high-level analysis of information and information systems by facilitating the IT Security assessment and authorization process, performing Privacy Impact Assessments and updating System of Records Notices (SORNS) for information technology (IT) systems in conjunction with the IT security authorization and system development life cycle process.
- Perform vulnerability assessment and compliance testing using Nessus and Cenzic web application scanning to render detailed reports of issues noncompliant with FISMA, OMB requirements, and regular patch management.
- Provide Bi-weekly New Employee Orientation (NEO) training with other Information security staff members on IT Security and Privacy best practices at the agency.
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- Implementation of the Compliance and Safety new hire orientation training to address fraud and abuse, HIPAA, and open communication
- Implementation of the Corporate Compliance Program based on the seven elements of an effective compliance program
- Implementation of the corporate wide online annual HIPAA Training
- Development and reporting of the Risk Management dashboard and Adverse Event tracking database, with monthly reporting to the Board of Directors
- Development and distribution of the Compliance Training Scorecard to create an awareness and facilitate timely completion of required trainings
- Auditing of HIPAA Privacy and Security, 340B, IT Security, & Financials
- Implement protocol for automated checking of the OIG, SAM database, Medical/Medicare Exclusion Lists
- Development of the Code of Conduct, Conflict of Interest, and other corporate policies and procedures
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