Compliance System Administrator and Investigator

Job Description

Job Description

As a Compliance Investigator and system administrator, you will be responsible for receiving, evaluating, triaging investigations or complaints brought to Hopebridge’s attention through a hotline, individual or group who believe that there has been a violation of policy or process.

You will need experience managing and customizing a compliance system to input investigations and track for resolution. As part of the investigation process, you will need experience in analyzing evidence, speaking to complainants and NHS/other government departments, and liaise with internal HR, Clinical, and Operational leaders to reach decisions on whether to uphold complaints. High-level responsibilities include but are not limited to reviewing and identifying complaint trends and issues, organizing and leading investigations associated with various allegations and assisting in the development of action plans for substantiated allegations. This position also requires the ability to take the data from the investigation system and track/trend in presentations for executive leadership. Responsibilities Essential Functions

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Conduct impartialinvestigations of incidents, in close collaboration with Legal Counseland other senior level staff.
• Receive confidential questions/concerns from employees, parents/guardians and community concerning compliance situations.
• Investigate questions/concerns receivedby email, voicemail, drop-ins, compliance hotline,etc. to determine specifics and provide recommendations for resolution or refer concern to appropriate individual(s) for additional investigation/follow -up.
• Respond to reports of incidents alleging Fraud, Waste, Abuse, HIPAA, and sentinel events in a thorough manner and, when necessary, conductinvestigations ; maintain clear communication with all involved parties.
• Plan and conductconfidential investigations of incidents and complaints; identifyand conduct interviews with all involved parties, gather and secure relevant documentation; analyze data, compare incident reports to legal standards and policies, and develop recommendations to address and resolve issues.
• Provide a detailed report summarizing the investigation/findings of the investigation, in accordance with company policy,and when applicable, local, state and federal rulesand regulations.
• Consult with regionalpersonnel on creatingand maintaining an equal opportunity environment and the interpretation and consistent application of local, state, and federal rules, regulations and policies.
• Work collaboratively with HR and other departments, for appropriate follow-up after report summaries and findingsof investigation(s) are completed to document corrective action and potential resolution.
• Assist clinics and associated regionalteam members with incidents and investigations regarding bullying.
• Assist in researchand development of training relatedto all aspects of compliance; identify training needs and implement broad-based and customized training across all levels of employees and students on compliance topics.
• Plan and conduct compliance monitoring reviews; verify documentation to support certified monitoring plans where applicable; develop recommendations for corrective actionbased on findings.
• Follow-up and monitorto verify that corrective actionshave been implemented.
• Analyze existing policies, identify gaps, and recommend new/revised policies, procedures, and approval processes.
• Serve as the primary systemadministrator for Hopebridge’s compliance intake system(hotline and case management platform), including managinguser access and permissions, configuring intake workflows and case routing rules, and maintaining system settings to ensure accurate and timely case handling.
• Monitor the compliance intake system’s performance and data integrity; troubleshoot issues, coordinate with IT and third-party vendors to resolvetechnical problems, and lead or support system upgrades, enhancements, and user acceptance testing.
• Develop, maintain, and distribute dashboards, scorecards, and reportsusing data analytics tools to track key compliance metrics, including case volume, case type, source, resolution timeframes, and outcomes.
• Analyze intake and investigation data to identifytrends, patterns, and emerging risk areas across the organization; translate findings into actionable insights and recommendations for compliance leadership.
• Safeguard the security,confidentiality, and integrityof all data housed withinthe compliance intake system, in accordance with HIPAA and Hopebridge data governance policies.
• Support internal and external audits of the intake system’s data, controls, and reporting processes, and maintain up-to-date system documentation, user guides, and standard operating procedures.
• Perform various administrative functions: processes transactional information; perform data entry and record updates for employee tracking, records maintenance, and database management.
• Prepare correspondence and memorandums; maintain files, forms, documentation and information in accordance with policies and procedures; performspecial projects as directed and prepare reports as required.
• Follow and promoteHopebridge’s mission and priorities in compliance with all policiesand procedures.
• Review contracts for compliance with district requirements.
• Perform other dutiesas assigned.
• Attends and participates in required educational training sessions and staff meetingsas scheduled and assigned
• Completes all assignedmandatory training modules.
• Follows all state and federallaws, including HIPAA.
• Maintain a clear criminal record

Required Skills Competencies

• Problem Solving and Analytical Skills
• Good Communication-Verbal and Written
• Attention to Detail
• Self-Management
• CollaborationSkills
• Data Analysis, Reporting, and Systems Proficiency

Required Education and Experience

• A Bachelor’s in Healthcare relatedfield
• Priority given to individuals with a certification in healthcare compliance (CHC)
• Prior experience investigating compliance concerns.
• Proficient knowledge of Microsoft OfficeSuite.
• Experience administering or utilizing a compliance case management/intake system(e.g., Healthicity, NAVEX, Convercent, EthicsPoint, or similar platform) preferred.
• Proficient in data analytics and visualization tools(e.g., Excel, Power BI, Tableau)to support compliance reporting and trend analysis.

Position Type/Expected Hours of Work

• This is a full-time position,Monday through Friday.

Physical Demands

• Prolonged periodssitting at a desk and working on a computer.

Work Environment

• Work is performed in a remotehome environment.

Other Duties

• Please note this job description is not designedto cover or contain a comprehensive listingof activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

Disclaimer

The above statements reflect general functions of this job and shall not be construed as a detailed description of all work requirements inherent in this job. The immediate supervisor may elaborate on or add to the above list if the duties come within the employee’s realm of responsibility.

Hopebridge is an Equal Opportunity Employer that does not discriminate on the basis of actual or perceived race, creed, color, religion, alienage or national origin, ancestry, citizenship status, age, disability or handicap, sex, marital status,veteran status, sexualorientation, arrest recordor any other characteristic protected by applicable federal, state or local laws.