This candidate’s most recent experience is as a Director of Compliance & Privacy/Security Officer at a non-profit health center with oversight of three community health centers and a mobile unit that provide medical, dental, and behavioral health services. Within this role, this candidate has had the opportunity to oversee the regulatory activities such as, but not limited to provider credentialing, audited claims processing, appeals, grievances, complaints, formulary administration, contract management, fraud waste and abuse (FWA), and board/committee governance.
This candidate has solid knowledge of healthcare related laws and regulations including Stark, Anti-kickback, False Claims Act, HIPAA, as well as HRSA Guidelines.
This candidate is an experienced leader having been the spearhead of several cross functional teams that overhauled organization-wide processes, programs and initiatives leading to better coordination across departments and timelier internal and regulatory reporting. This candidate has overseen small- & large-scale projects aimed at eliminating redundancies, standardizing processes, analyzation of root causes of deficiencies, & process mapping to identify & correct gaps/deficiencies. This candidate revised/revamped Compliance Programs and provides compliance training to all employees at their organization. Additionally, this candidate has experience as Privacy and Security Officer.
This candidate has a Master of Science in Health Informatics, is a Registered Health Information Management Administrator (RHIA) and is certified in Healthcare Privacy and Security (CHPS).