HealthCare Compliance

Screening, credentialing  and  monitoring of health care employees is challenging. The landscape is constantly changing as the requirements increase. Human Resource and Compliance Departments at health care facilities and hospitals routinely struggle to keep up with the demands placed on them by the myriad of regulations and state and federal laws that must be adhered to every day.  The penalties for non-compliance are costly.  This makes compliance a priority for anyone working in this industry.  HRintuitive has the expertise and experience in assisting health care organizations with achieving their objectives.

Drive Compliance Objectives in the Organization:

  • Review applicable federal and state laws and regulations to determine appropriate criteria necessary for screening candidates and employees.
  •  Review information being reported by vendor to determine compliance with state and federal laws.
  • Review policies and procedures in place for screening and continual monitoring of the Federal exclusions list (OIG LEIE / GSA EPLS) as well as the individual state medicaid lists.
  • Review usage of information by client to determine compliance with regulatory agencies and applicable state and federal laws.
  •  Design compliance/audit processes that scale with the organization’s volume and projected growth.
  •  Build Cross-Functional partnerships- work with legal, compliance, employee relations and other departments to achieve compliance objectives, develop partnerships with HR Managers and Business Partners across locations to achieve objectives

Cost- Benefit Review/Analysis:

  • Review services being ordered with the job description and requirements. Evaluate job relativity to the information being obtained and make appropriate recommendations.
  •  Evaluate any gaps in services being ordered either by job description or location.
  • Develop and evaluate Key Performance Indicators to measure benefits of the program.
  • Evaluate pricing in an effort to balance cost with value, determine areas where there is duplicity or where there is room to achieve efficiencies.

Vendor Management:

  • Establish KPI for vendors.
  •  Review SLA and determine whether service is meeting the criteria.
  •  Resolve ongoing/recurring issues.
  • Obtain feedback across locations regarding vendor performance/outstanding issues.
  • Evaluate vendor performance.

Technology:

  • Evaluate current work flow of information and determine gaps in efficiencies or areas that could be automated.
  • Evaluate solutions for increasing efficiencies through technology integrations with ATS or HRIS systems.
  • Work with technology partners to resolve ongoing or reoccurring issues.
  •  Evaluate new/proposed technology solutions or integrations involving the screening process.

Data Privacy:

  •  Ensure that confidential information is being obtained, transmitted and stored in a secure environment.
  •  Ensure that any information being sent offshore is disclosed in compliance with applicable laws