Medical Compliance Specialist 2, Regulatory (Conflict of Interest)
University of Miami


Job Info


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Transforming Lives

The University of Miami is among the top research universities and academic medical centers in the nation, and one of the largest private employers in South Florida.

With more than 16,000 faculty and staff, the University strives for excellence, and is driven by a powerful mission to transform and impact the lives of its students, patients, members of the community, and people across the globe.

The University is committed to fostering a culture of belonging, where everyone feels valued and has the opportunity to add value. Through values of Diversity, Integrity, Responsibility, Excellence, Compassion, Creativity, and Teamwork (DIRECCT) the U community works together to create an environment driven by purpose, excellence, community, and service.

The Sylvester Comprehensive Cancer Center has an exciting opportunity for a Full-Time Medical Compliance Specialist 2, Regulatory (Conflict of Interest) to work on the UHealth Campus. The Medical Compliance Specialist 2, Regulatory (Conflict of Interest) is part of the Regulatory Compliance team that promotes health care compliance within University of Miami Health System/University of Miami/ Miller School of Medicine. Under the direction of the Associate Director of Regulatory Compliance and/or Director of Regulatory Compliance, the Medical Compliance Specialist 2 is responsible for conducting research, performing audits, assisting and monitoring investigations, documentation review and analyzing the UHealth/University of Miami Miller School of Medicine Policies, Rules and Regulations. He/she will contribute to the success of the regulatory compliance program by implementing processes that relate to conflict of interests in the clinical settings, strategizing compliance risk assessment, summarizing and documenting compliance-related UHealth/University of Miami Miller School of Medicine policies and procedures and assisting with conflict of interest related reviews and investigations. He/she will maintain accurate records of division actions and will document communication with members of the medical community, regulatory entities and any others involved in the medical enterprise.

Primary Duties and Responsibilities:


  • Perform fee-for-service contract reviews for UHealth Clinical Providers.

  • Assist with escalation process for contract reviews.

  • Perform reviews of UHealth Clinical provider disclosures of outside compensation/interests and any necessary investigative reviews.

  • Perform reviews of Open Payment Data (or similar data sources) compared to internal disclosures and any necessary investigative reviews.

  • Conduct detailed research and reviews of policies and procedures in support of the UHealth Regulatory Compliance program, which are assigned and prioritized by the Director of Regulatory Compliance.

  • Assist and support the work of the Assistant Director and Director in the regulatory arena.

  • Conduct conflict of interest reviews and investigations as needed.

  • Identify and report general compliance issues that may arise through the work process.

  • Write and revise policies and standard operating procedures.

  • Generate and organize audit finding reports. Analyze audit outcomes and proactively identify trends. Provide timely and concise audit, review, and investigational feedback to the Associate Director.

  • Maintain current knowledge of changes in national and local Healthcare Rules and Regulations.

  • Maintain current knowledge, communicate changes and serve as an educational resource of various areas of regulatory concerns, including but not limited to, physician contracting, emergency medical treatment & labor act (EMTALA), Stark law, anti-kickback statute, civil monetary penalties, false claims act, and any other regulatory issues that arise.


This list of duties and responsibilities is not intended to be all-inclusive and may be expanded to include other duties or responsibilities as necessary.

MINIMUM QUALIFICATIONS

  • Bachelor's Degree in relevant field

  • Minimum 3 year of relevant experience, including externship/internship experience, in health related, law or regulatory field or comparative experience and/or education.

  • Physician contracting or conflict of interest review/investigational experience, preferred.

  • JD or RN preferred.

  • Must have an understanding of regulatory compliance and be familiar with federal and state healthcare regulatory agencies.

  • Knowledge of documentation guidelines in an academic medical center preferred.

  • Excellent communication (written and verbal) skills.

  • Detailed oriented person with strong organizational, analytical, interpersonal and motivational skills required.

  • Ability to work as a team player and to collaborate well with others.

  • Strong computer skills utilizing Microsoft Office suite (i.e., Word, Excel, Access, PowerPoint), other web-based applications.

  • Proven ability to handle sensitive and confidential information appropriately.

  • Maintain strict confidentiality of all matters.


Any appropriate combination of relevant education, experience and/or certifications may be considered.

The University of Miami offers competitive salaries and a comprehensive benefits package including medical, dental, tuition remission and more.

UHealth-University of Miami Health System, South Florida's only university-based health system, provides leading-edge patient care powered by the ground breaking research and medical education at the Miller School of Medicine. As an academic medical center, we are proud to serve South Florida, Latin America and the Caribbean. Our physicians represent more than 100 specialties and sub-specialties, and have more than one million patient encounters each year. Our tradition of excellence has earned worldwide recognition for outstanding teaching, research and patient care. We're the challenge you've been looking for.

Patient safety is a top priority. As a result, during the Influenza ("the flu") season (September through April), the University Of Miami Miller School Of Medicine requires all employees who provide ongoing services to patients, work in a location (all Hospitals and clinics) where patient care is provided, or work in patient care or clinical care areas, to have an annual influenza vaccination. Failure to meet this requirement will result in rescinding or termination of employment.

The University of Miami is an Equal Opportunity Employer - Females/Minorities/Protected Veterans/Individuals with Disabilities are encouraged to apply. Applicants and employees are protected from discrimination based on certain categories protected by Federal law. Click here for additional information.

Job Status:
Full time

Employee Type:
Staff

Pay Grade:
c105



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