Medical Management Manager jobs in Johnstown, PA

Description

Under the supervision of the CEO, the Director of Risk Management and Corporation Compliance is responsible for coordinating and ensuring compliance to Mountain Laurel Medical Center’s risk assessment plan, corporation compliance plan and HRSA regulatory requirements. The Director works closely with other department management to complete and review audit requirements, site reviews, and remediation of identified risk elements. Monitoring of these reviews and action plans are reported through various Board and internal committee structures.

A. Risk Management Responsibilities
1. Production of Annual Risk Assessment Plan, Outcomes, and Corrective Actions (as necessary).
2. Present to Board and Board Committee(s) annual Risk management plan.
3. Intake, Resolution and trending of Patient Complaints.
4. Management of MLMC Insurance plans and broker relationship (property, injury, cybersecurity, etc).
5. Safety Officer role.
6. Chair of Emergency Preparedness Committee and coordination of essential elements.
7. Project Manage and conduct Annual Risk Tabletop Exercise.
B. HRSA Regulatory Responsibilities
1. Prepare, review and submit annual FTCA application.
2. Coordinate triennial Operational Site Visit (OSV) with Executive Team.
3. Coordinate triennial Service Area Competition (SAC) with Executive Team.
4. Liaison for FTCA related elements of compliance and legal proceedings.
C. Corporation Compliance Responsibilities
1. Functioning Corporate Compliance Officer (CCO).
2. Functioning Privacy Officer.
3. Chair of MLMC Internal Corporation Compliance Committee.
4. Present as CCO to the Compliance Committee of the Board (and working with Chair of the Committee on agenda/content).

5. Coordinate annual Audits, reporting and corrective actions in accordance with MLMC Compliance Audit plan.
6. Ensure Compliance to MLMC’s Office of the Inspector General (OIG) work plan.
7. Facilitate Policy development, review, edits and approval process.
D. Other Responsibilities
1. Remain current and communicate federal/state/local legislative affairs (annual legislative assembly for MD and WV).
2. Legal Liaison with General Counsel/CEO.
E. Provides excellent customer service for all employees and patients.
F. Other duties assigned by the CEO.
G. Upholds the Code of Ethics and mission of Mountain Laurel Medical Center in a manner consistent with the core values of patient focused, respect, accountability, teamwork, continuous improvement, and integrity.

Qualifications

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily and possess the ability to interact effectively with individuals in a broad range of situation in an increasingly challenging and complex work environment. Must also possess the ability to use discretion and confidentiality at all times, ability to multitask, prioritize and manage workload, and the ability to work independently with little supervision, Must possess the ability to interact and support team members and leadership at all levels, excellent verbal and written communication and organizational skills, and the ability to establish and maintain a positive and effective work relationships with coworkers, members, providers, and customers. The requirements listed below are representative of the knowledge, skills and abilities required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Working in the administrative office may expose this position to sensitive and/or confidential information that must be held in confidence.

Education and Experience:
Combination of 3 to 5 years risk management experience and/or compliance, quality or auditing related experience preferred in a healthcare environment. Clinical licensure (i.e. RN) required, and/or extensive healthcare background. Excellent computer, communications, and organizational skills are required. Bachelor's  degree required and Specialized education/training/certification in risk management and compliance fields.

Computer Literacy:
Extensive knowledge of computer software and proficiency in or knowledge of Microsoft Office, Google Suite, and other applications.

Work Record:
A demonstrated work record showing good attendance, punctuality, dependability, and the ability to work well with supervisors and coworkers as part of a team effort is essential. A medical office setting is an environment that requires the ability to relate to all types of people while always maintaining a professional demeanor.

Language Skills:
Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals is essential. Ability to write routine reports and correspondence, and the ability to speak effectively to patients, co-workers and the public at large is paramount.

Mathematical Skills:
Must have the ability to calculate figures, amounts, proportions, and percentages with mathematical accuracy and attention to detail.

Reasoning Ability:
Must be able to demonstrate the ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.

Team Work:
An essential element is the ability to work and interact effectively and positively with other staff members to build and enhance teamwork in a patient centered team-based model of care and in the overall MLMC organization; team engagement is a must to be successful in this position.

Sensitivity to Confidentiality:

Must be able to demonstrate a high level of confidentiality and the ability to manage all company information accordingly.

Sensitivity to the Needs of Special Populations:
Must be able to demonstrate the ability to understand and respond appropriately, effectively and sensitively to special population groups served by MLMC. Special population groups include those defined by race, ethnicity, language, age, sex, sexual orientation, economic standing, disability, religion, etc.

Understanding of HealthCare laws and Regulations:
Must have the ability to follow HIPAA guidelines as well as an understanding of policies and procedures regarding medical records put in place by the Federal Government.

Physical Demands:
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. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is frequently required to drive, sit, handle papers, type, operate computer equipment, reach with hands and arms, talk, see, and hear. Specific vision abilities required by this job include close vision and the ability to adjust focus.

Work Environment:
Work is performed in a typical business office environment. Some local trips by automobile may be required (i.e., Post Office, office supplies, etc.). Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the job.