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The Manager will support the Sr. Director of Corporate Compliance to ensure implementation of appropriate policies and procedures, support compliance training, conduct investigations and maintain a system of reporting and ensure the integrity of all compliance investigations, direct and coordinate internal audits, and monitor HIPAA/Patient Privacy compliance.
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Conduct legal research on complex areas of law involving regulations, legislation, privacy, and HIPAA. Provide legal advice to agency personnel on complaints, investigations, and compliance regarding use of funds and fraud/waste/abuse.
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Provide legal advice to the Chief Financial Officer and divisional personnel around federal funding sources, appropriate use of state and federal dollars for programs, grants, and contracts. Issue spot and assist with providing reporting and analytics related to internal investigations and compliance issues and trends.
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Working knowledge of compliance related regulations such as coding, billing, documentation requirements, Local and National Coverage Decisions, National Comprehensive Coding Initiatives, Medicare/Medicaid billing regulations, the HIPAA Privacy Rule, etc.
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Commercial Legal Counsel: In addition to the role of lead privacy counsel, you will act as the lead commercial attorney for functional segments of the business in partnership with the Diabetes legal team – providing advice and counsel on commercial contracting, healthcare compliance and regulatory matters, M&A and strategic transactions, litigation and investigations, intellectual property and other general legal matters.
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Corporate Transactions: Assist and/or coordinate the due diligence process for mergers, acquisitions, and other corporate transactions involving NCH. Provide or coordinate legal advice and support for these transactions to ensure compliance and mitigate risks.
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With support from Legal department, lead internal investigations related to the compliance program and if required, implementation of applicable corrective and preventative measures and reporting to relevant government agencies.
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Working effectively with representatives of the U.S. Department of Health and Human Service's Office for Civil Rights (OCR), state regulators and/or other legal entities as well as appropriate internal partners during government initiated privacy or data security related reviews, audits or investigations.
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Collaborate with IT management, the legal department, fraud department, human resources and law enforcement agencies to resolve security vulnerabilities or support investigations. Knowledge of Industry Security and Privacy Standards (e.g. HIPAA, PCI, GDPR, etc.
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O Litigation Support: Assist in legal matters, disputes, or legal actions related to patient privacy and HIPAA compliance. Privacy Legal Counsel: Advise the business, a HIPAA covered entity with a US direct to patient business model, on privacy related matters regarding compliance, data governance, regulatory interpretation and all domestic and international privacy related regulations affecting the business.
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Familiarity with data privacy and security regulations, such as GDPR or HIPAA, and their implications for eDiscovery. The person filling this position ideally has knowledge of and experience with eDiscovery issues from an in-house perspective, must be an effective communicator, and have the ability to work with colleagues in Legal and diverse functional and operational areas throughout the company (such as HR, Finance, Pharm Ops., Business Development, IA, IS, etc.
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Candidates may substitute the possession of a Bachelor's degree in the field of criminal justice, criminology, law enforcement or an allied health field, (such as nursing, pharmacy, psychology, social work, nutrition, dietetics, speech pathology, audiology) from an accredited college or university and four years of experience conducting criminal investigations, including the preparation of analyses and reports for use in legal proceedings for the required experience.
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Provides subject matter expertise to Business Unit Ethics and Compliance Officers for privacy investigations, coordinating with the Privacy and Security Officer, the Assistant Security Officer, Divisional Privacy and Security Officers, Business Unit Ethics and Compliance Officers, and legal counsel as appropriate.
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A strong track record of timely, active and appropriate responses to privacy violation allegations, inquiries, incidents and investigations, including working effectively with legal counsel and stakeholders is desired.
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Partners and collaborates with the Legal and Compliance teams on complex EEOC complaints , Subpoenas, and Employee Relation Investigations, Hotline Compliance complaints, HIPAA and Patient Privacy Violations.
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