• Job Description

  Req#: R124867

  This role will oversee (a) the healthcare, HIPAA, and privacy compliance program related to Henry Schein’s home medical equipment and products and supplier businesses, (b) HIPAA and privacy compliance for Henry Schein Inc.’s medical and dental businesses, and its health benefits plans for US employees; and (c) any other Henry Schein entities offering services related to claims processing for medical services, dental services, prescription drugs or devices (e.g., coding, billing and/or collections) in the United States. This position is part of Henry Schein’s global ethics & compliance program.

  Responsibilities include but are not limited to, serving as the HIPAA Privacy Officer for relevant Henry Schein entities; serving as an in-house expert on home medical equipment, product, and supplies billing, coding, and medical records documentation; developing and standardizing policies and procedures related to coding, billing, medical records documentation, revenue cycle compliance matters, HIPAA and state privacy laws; auditing and monitoring; developing content for compliance learning and communications; conducting training and education sessions with relevant TSMs; conducting compliance investigations; and preparing reports.

  KEY RESPONSIBILITIES:

  • Serve as HIPAA Privacy Officer for relevant Henry Schein entities, accountable for the HIPAA privacy program
  • Serve as an internal compliance expert and advisor to business partners on compliance matters related to home medical/dental equipment, products or supplies coding, billing, medical records documentation, HIPAA (Privacy Rule, Security Rule, and Breach Notification Rule), and other state privacy laws, conflicts of interest, etc.
  • Reduce organization risk by conducting periodic risk assessments across various areas, such as HIPAA, billing and revenue cycle, and overseeing risk mitigation plans
  • Conduct periodic data inventories
  • Ensure policies and procedures are accurate, current, and in compliance with federal and state regulations
  • Lead and/or participate in projects related to the design, implementation, revision, and maintenance of processes and systems that promote compliance related to the sale of medical and dental equipment and products
  • Create and deliver education related to compliance topics such as coding and billing compliance, HIPAA and data protection compliance, conflicts of interest, etc. using various modalities such as e-modules, in-person training, toolkits, communications, the Ethics & Compliance team’s intranet site, and other tools
  • Monitor, analyze, interpret, and communicate regulatory changes related to coding, billing, medical records, and HIPAA/privacy documentation. Lead and oversee efforts to respond to new or changing regulations, including but not limited to communicating regulations to site leadership and affected departments, assembling, and chairing work teams, and developing/providing education regarding regulatory requirements
  • Interpret and disseminate information on regulatory and compliance matters
  • Ensure compliance with new rules, regulations, and revisions, as set forth by the Center for Medicare and Medicaid Services (CMS), Office for Civil Rights (OCR), as well as other federal and state laws and regulations, and private insurance carriers that govern matters related to claims processing and submission, the revenue cycle, privacy/data protection
  • Liaise with Henry Schein’s IT and Office of Cyber Security teams to ensure HIPAA Security Rule requirements are satisfied
  • Establish and chair the relevant Compliance Committee for covered entities
  • Monitor and track data and create reports to assist in the analysis of compliance issue patterns
  • Collaborate with the corporate Ethics and Compliance team, Human Resources, key leadership, and others as needed (e.g., law firms, consultants) to identify, investigate, and resolve suspected misconduct along with recommendations about appropriate disciplinary or remedial action for confirmed violations of law or policy
  • Conduct internal audits to ensure compliance with Stark law, Anti-kickback statute, Conflicts of Interest, Fraud, Waste and Abuse, and other relevant laws and regulations
  • Oversee and document external regulatory inspections, audits, and investigations and third-party billing audits related to compliance topics
  • Perform follow-up to ensure repayment of any identified overpayments received from any health plan and/or patients
  • Perform other duties as assigned or as necessity dictates

  SPECIFIC KNOWLEDGE & SKILLS:

  • At least five years’ healthcare compliance/regulatory experience in the home medical equipment, products or supplies distribution industry, or related settings such as hospitals, ambulatory centers, or clinics. Experience should include planning and implementing large-scale projects that affect multiple departments and functions; implementing regulatory changes; identifying, investigating, and resolving complaints; and analyzing and interpreting billing requirements
  • Strong knowledge and understanding of:
    • Federal healthcare program reimbursement rules and regulations for home medical equipment, products, and supplies (e.g., Medicare, Medicaid, TriMed, Federal Employees Health Benefits Programs (FEHBP), Children’s Health Insurance Program (CHIP))
    • State healthcare program reimbursement rules and regulations for home medical equipment, products, and supplies (e.g., Medi-Cal, Medicaid NYS DOH)
    • Healthcare privacy laws (e.g., HIPAA, California Consumer Privacy Act (CCPA) as amended by California Privacy Rights Act (CPRA), Virginia Consumer Data Protection Act (VCDPA), Connecticut Data Privacy Act (CTDPA))
    • Fraud and abuse laws (e.g., Anti-kickback statute, Stark Law, False Claims Act)
    • Private payer requirements
  • Knowledge of processes related to coding and billing for home medical equipment, products, and supplies, including but not limited to Local and National Coverage Decisions, Advanced Beneficiary Notices, Medicare Secondary Payor questions, write-offs, and charge master management
  • Understanding of healthcare compliance programs and prior experience developing, implementing, and managing compliance programs across the 7-plus elements
  • Experience with coding and billing requirements for medical/dental services and/or products (including prescription devices), policy development and implementation, and/or auditing in this area
  • Evidence of HIPAA or data privacy training required
  • Other certifications are preferred, but not required
  • Strong change management skills
  • Demonstrated leadership skills and abilities, including the ability to lead diverse and remote work teams
  • Demonstrated personal traits of a high level of motivation, team orientation, professionalism, and trustworthiness, and placing a high value on treating others with dignity and respect
  • Strong skills in personal diplomacy with a demonstrated ability to handle sensitive communications with leadership, management, suppliers, customers, legal counsel, and regulatory agencies

  GENERAL SKILLS & COMPETENCIES:

  • Broad and unique range of professional skills with an expert understanding of industry practices
  • Excellent proficiency with tools, systems, and procedures (e.g., Microsoft Office tools - Word, Excel, and PowerPoint or similar products)
  • Strategic planning/organizational skills and techniques
  • Excel at independent decision-making, analysis, and problem-solving skills
  • Outstanding verbal and written communication skills
  • Polished presentation and public speaking skills
  • Strong interpersonal skills
  • Ability to resolve conflicts and deliver difficult messages professionally
  • Use skill and influence to develop company objectives and principles and to achieve goals in creative and effective ways
  • Excellent negotiating skills
  • Project management, consultative skills, and ability to manage a budget
  • Ability to cultivate and develop lasting internal and external customer relations
  • Strong financial skills

  MINIMUM WORK EXPERIENCE:

  Typically 12 or more years of increasing responsibility and complexity in terms of any applicable professional experience, of which at least 5 years is in the specific industry listed above.

  PREFERRED EDUCATION:

  Typically a Bachelor's Degree or global equivalent in a related discipline. Master's or law degree or global equivalent preferred. May hold two or more industry certifications.

  Medical coder certification is required and advanced knowledge of ICD and CPT coding

  TRAVEL / PHYSICAL DEMANDS:

  Travel typically 25%.

  The posted range for this position is $137,600-$216,720, which is the expected starting base salary range for an employee who is new to the role to fully proficient in the role. Many factors go into determining employee pay within the posted range including prior experience, current skills, location/labor market, internal equity, etc.

  This position is eligible for a bonus not reflected in the posted range.

  Other benefits available include Medical, Dental, and Vision Coverage, a 401K Plan with Company Match, time off, Paid Parental Leave, Income Protection, Work Life Assistance Program, Flexible Spending Accounts, Educational Benefits, Worldwide Scholarship Program, and Volunteer Opportunities.

  For more information about career opportunities at Henry Schein, please visit our website at: www.henryschein.com/careers

  Henry Schein, Inc. is an Equal Employment Opportunity Employer and does not discriminate against applicants or employees on the basis of race, color, religion, creed, national origin, ancestry, disability that can be reasonably accommodated without undue hardship, sex, sexual orientation, gender identity, age, citizenship, marital or veteran status, or any other legally protected status.

  For more information about career opportunities at Henry Schein, please visit our website at: www.henryschein.com/careers

• About the company

  Henry Schein, Inc. is an American distributor of health care products and services with a presence in 32 countries.

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