Legal Support and Compliance Specialist

• 2424
  
• Houston, Texas
  
• VPE
  
• Full Time
  

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The Legal Support and Compliance Specialist is responsible for supporting the General Counsel and Chief Compliance Officer (GC/CCO) in completing legal-related tasks with minimal supervision. Responsibilities include: leading contract lifecycle management function and system, responding to standard and complex medical record requests and subpoenas, mitigating organizational risk due in conjunction with Risk and Quality Management (RQM) leadership, and managing Vendor Risk Assessment (VRA) lifecycle management. Supports the organization’s strategic plan and workplace inclusion initiatives. Ensures productivity expectations, customer service and compliance standards are maintained. Abides by the organization’s mission in performing job duties. Demonstrates an understanding and commitment to PPGT’s culture of quality, safety and risk awareness.

• Partners with Risk and Quality management leadership to understand and mitigate risk to the organization. Conducts research and coordinates actions with GC/CCO.
  
• Supports GC/CCO in response to adverse events.
  
• Effectively communicates the importance of legal and regulatory compliance with state and federal laws and regulations, across all levels of the Affiliate.
  
• Partners with Senior Vice President of Quality and Risk (Sr VP of RQM) in efforts to prevent, detect and correct occurrences of healthcare fraud and abuse.
  
• Serves as a resource for assigned workgroups, task forces or committees that support improvement of the affiliate�s compliance initiatives and requirements.
  
• Liaison to GC/CCO to oversee and administer the process of self-reporting to government agencies when appropriate and necessary.
  
• Assists GC/CCO in management of the affiliate�s comprehensive risk management program, identifying potential risk exposure that could impede the reputation, safety, security, or sustainability of the Affiliate.
  
• Recommends risk prevention strategies and mitigation plans, implement approved programs, promote loss prevention, and monitors compliance.
  
• Aid and work with risk assessment project teams as needed for quick response to cross-departmental high-risk issues.
  

• Under direction of GC/CCO, conducts thorough legal research, identifies relevant statutes, case law, and other legal resources.
  
• Manages various legal and organization documents, contracts, correspondence, and other compliance matters.
  
• Medical Records Requests:
  

o Responsible for responding to medical record requests and working with RQM, Health Services and other applicable departments to address responses to record requests and subpoenas; such requests may require a legally compliant release of records or the rejection of such request unless and until lawfully acceptable request is received by the affiliate.

• Contract Management:
  

o Leads the contract lifecycle management workflow using iManage contract management system.

o Develops and maintains processes that assure the accuracy and integrity of data entered into the contract management system for all contract specifications and terms.

o Ensures Business Associate Agreements (BAAs) are obtained from any third party that will be exchanging or accessing personal health information (PHI) as indicated in the terms of the related business contract by, including but limited to reviewing, assessing, and maintaining all business associate agreements to ensure compliance with Health Insurance Portability and Accountability Act (HIPAA) regulations and Planned Parenthood Federation of America (PPFA) accreditation requirements; where areas of non-compliance are noted, make recommendations for modification to ensure compliance.

o Facilitates the review of all contract documents from pre-contract through post signature phases including collaboration with teammates to resolve issues and develop alternative review, approval, and/or signatory arrangements when necessary.

o Develop and maintain processes that provide timely notification of critical contract events (e.g., renewals, termination, and due dates contained within the agreements).

• Vendor Risk Assessment (VRA):
  

o Leads the VRA lifecycle management workflow as required by the affiliates VRA policy and procedures.

o In partnership with Business Operations and Information Technology (IT), maintain processes that assure the accuracy and integrity of data entered into the VRA management system for all VRA specifications and terms.

o Ensure business associate agreements are obtained from any third party that will be exchanging or accessing personal health information (PHI) as indicated in the terms of the related business VRA.

o Facilitates the review of all VRA documents from pre-contract through post signature phases including collaboration with teammates to resolve issues and develop alternative review, approval, and/or signatory arrangements when necessary.

o Develop and maintain processes that provide timely notification of critical events (e.g., renewals, termination, and due dates contained within the agreements and cyclical VRA updates).

• Has unrestricted access to paper and electronic patient protected health information (PHI) and health records for purposes of treatment, payment, and/or healthcare operations. The use of a patient�s protected health information should be limited to information needed for the specific task that is being performed or requested by the individual patient. Disclosure of any patient information must be for purposes of treatment, payment or healthcare operation OR must be accompanied by valid patient authorization. Must adhere to minimum necessary rule.
  
• Duties and responsibilities may be added, deleted, or changed at any time at the discretion of management, formally or informally, either verbally or in writing.
  

Bachelor’s degree + 3 years of relevant experience or Associate’s degree + 5 years of relevant experience or H/S diploma (or equivalent) + 7 years of relevant experience.

Relevant experience: healthcare compliance, paralegal, risk and quality management or related experience. Healthcare industry experience preferred.

Healthcare Compliance or Paralegal certification preferred.

Must have excellent computer skills with knowledge of Microsoft Word, Excel, PowerPoint, Outlook, and Internet. Must have the willingness and ability to adapt to change including advances or new technology. Must have excellent customer service skills and be committed to providing the highest level of customer satisfaction.

PPGT is an equal opportunity employer. We strictly prohibit unlawful discrimination of any kind, including discrimination on the basis of age; race, color, ancestry, national origin, or ethnicity; citizenship status; sex or gender; gender identity or gender expression or transgender status (including the individual's actual or perceived sex and the individual's gender identity, self-image, appearance, behavior, or expression); sexual orientation (including actual or perceived heterosexuality, homosexuality, bisexuality and asexuality); mental or physical disability; AIDS, AIDS Related Complex, or HIV status; perception of risk of HIV infection; or association with individuals who are believed to be at risk; religion or creed; genetic information; pregnancy status, including related medical conditions; marital status; past, current, or prospective service in the uniformed services; or any other basis protected by law. We are a drug-free and tobacco-free workplace.

Applicants have rights under the Federal Employment Laws. To view these notices, please click on the following links: Family and Medical Leave Act (FMLA) poster: Equal Employment Opportunity (EEO) poster; and Employee Polygraph Protection Act (EPPA) poster.

• Must be able to travel as required.
  
• Ability to think strategically and achieve organization�s goals.
  
• Ability to provide oversight of compliance and regulatory requirements pertaining to position.
  
• Strong organizational skills and ability to multi-task.
  
• Ability to effectively use organization�s computer systems.
  
• Ability to manage details and complexity, to handle a variety of tasks simultaneously and to work under pressure.
  
• Strong interpersonal and communication skills.
  
• Ability to exercise initiative, sound judgment, and problem-solving techniques in the decision-making process.
  
• Effective leadership capabilities.
  
• Be discreet and safeguard confidential information.
  
• Possess integrity and compliance - can be relied upon to act ethically.
  
• Ability to provide effective, equitable, understandable, and respectful quality care and services that are responsive to the diverse cultural health beliefs and practices, preferred language, health literacy and other communication needs.
  
• Industry Awareness: Remains aware of PPFA accreditation standards and of the reproductive health environment�s regulatory compliance requirements. Understands how accreditation standards, regulatory agencies, funding, the external marketplace and competitive environment drives change within the organization.
  
• Organizational Awareness: Demonstrates a comprehensive awareness of the impact and implications of decisions and actions on other areas (departments or clinics) within the organization.
  
• Work Management: Effectively manages time as a resource; establishes realistic priorities; schedules own time and activities effectively; gives balanced focus and attention to appropriate long- and short-term priorities. Develops action plans and budgets; leverages technology; anticipates obstacles; establishes check points and monitors progress.
  
• Recovery Skills: Responds effectively and acknowledges responsibilities when clients (internal or external) experience problems or mistakes; rectifies the situation to restore client satisfaction; seeks information and collaborates with others to take action to implement permanent fixes. Maintains stable performance and emotions when faced with opposition, pressure, and or stressful conditions.
  
• Building Relationships: Shows genuine interest in others� needs and opinions; establishes rapport; earns the confidence and trust of others; demonstrates consistency between words and actions; delivers on commitments.
  
• Exemplify the organization�s In This Together values: We Tend to the Team; We Respect and Honor All People; We Jump In; We Try and We Learn; We Care for our Business; and We Return to our Mission.
  

Must be able to work primarily with fingers such as picking, pinching, or typing. Must be able to talk such as convey detailed or important spoken instructions to other workers accurately. Must be able to hear such as the ability to receive detailed communication orally. Must be able to communicate effectively. Will have substantial movements of the wrists, hands, and/or fingers. Must be able to have close visual acuity to perform an activity such as: preparing and analyzing data and figures; transcribing; viewing a computer terminal; extensive reading; visual inspection involving small defects. Sedentary/Office environment.