Focused Compliance Professional bringing 10 years of expertise in regulatory compliance, audit procedures, project oversight and risk management. Excellent history of delivering effective leadership and training to support staff development. Driven and strategic with an aptitude for program management. Advanced knowledge of audit methodologies, functions and compliance teams.
Skills
Healthcare Compliance
Regulatory Compliance
Risk Assessment
Risk Management strategies
Policy Implementation
Controls Evaluations
Due Diligence
Trend Monitoring
Compliance Reviews
Investigative Reporting
Litigation Support
Policy Development
Policy Enforcement
Project Management
Microsoft Suite, Google Suite, Adobe
EEOC and Labor laws, GDPR Regulations, DOJ, FAR, 501(c)(3)
TJC accreditation and audits, CMS, OMIG, OIG, DOH, OSHA, HIPAA, Fraud, Waste and Abuse, 42CRF Part 2, Article 16, Article 28, ACCME, HEDIS, Medicaid, Medicare, Westlaw, Statelink, Lexis Nexis
Experience
09/2019 to 01/2022
Compliance OfficerCape Cod Five Cents Savings – Wareham, MA,
Responsible for monitoring, tracking, negotiating and implementing compliance policies and procedures, grants, loan agreements and contract requirements, while providing compliance reports to CEO (Chief Executive Officer) and General Counsel in legal department.
Monitored borrower’s COI’s (Certificate of Insurances), fraud and tax regulations, tax returns, business certificates, legal draft and executed agreements, UCC (Uniform Commercial Code) filings and commercial and residential licenses.
Analyzed reports, CDFI (Community Development Financial Institution) awards and loans, commercial lending, workforce contract agreements, monitored loan servicers and borrower’s portfolio to ensure compliance regulations are being followed internally and externally with state and federal regulations.
Developed Code of Conduct, policies and procedures, internal and external compliance reports and systems in accordance internal and external state and federal regulations.
Determined organizations risk profile by directing risk and assessment control team in executing organization-wide assessments.
Conducted site visits to evaluate operations of grantees and borrower’s compliance with grant and loan agreements.
Developed SOP's (Standard of Procedures).
Initiate, lead and track compliance investigations.
Prepared and presented monthly loans analysis reports and made recommendations to Senior Management and board committee regarding loan portfolio performance, including allowances for doubtful accounts.
Worked inter-departmentally to monitor and approve project-related disbursements.
Monitored compliance risk controls to identify deviations and offer recommendations.
Established internal controls and processes to support compliance through project management, and engagement of key stakeholders.
Conducted extensive research to support regulatory findings and control weaknesses.
Utilized risk management techniques and business knowledge to improve compliance programs.
Established working relationships with regulatory agencies.
Developed systems to track and monitor compliance with regulatory requirements and internal policies.
Performed testing to evaluate processes, enhance test scripts and analyze results.
Maintained and revised policy procedures for general operation of compliance program.
Organized training programs to educate company staff on benefits and consequences of complying or defying regulations.
Planned and executed compliance audits with CFO to check company policies, procedures and controls.
Liaised between regulatory agencies and internal departments to facilitate regulatory and related matters.
12/2016 to 08/2019
Hospital Compliance Assistant DirectorIsland Peer Review Organization – City, STATE,
Traveled to New York State teaching and affiliated hospitals/facilities regarding post-graduate trainee working hours and conditions for onsite surveys/audits, on behalf of New York State Department of Health (NYDOH).
Responsible for Lake Success, NY and Albany, NY office coordination, day-to-day operations, supervision of hospital compliance teams and all reporting(s) onsite and offsite.
Oversaw compliance reviewer staff onsite to ensure smooth survey process, while strategically resolving and minimizing challenges, as well as offsite daily office operations and working hours.
Analyzed, collected and reported all onsite data to be processed to New York Department of Health (NYDOH) in timely manner.
Provided internal compliance investigations with risk management reports and detail findings; assisted with external compliance investigations and outside counsel to organization.
Maintained and implemented corporate compliance plan and code of conduct internally, Fraud, Waste and Abuse policies, while serving as Privacy Officer for all internal and external compliance violations.
Provided and worked closely with management team on coordinating onsite and pre/post surveys.
Maintained DOH, OIG, OMIG, TJC, DOJ and CMS regulations, policies, and procedures.
Monitored conflict reports and exclusions list for all new hires and existing stakeholders.
Provided quarterly and yearly risk assessments.
Assisted with overseeing departments contract budget while effectively and adequately using funds towards department and team objectives.
07/2013 to 12/2016
Administrative and Purchase Order Senior ManagerNorth Shore LIJ Health System – City, STATE,
Provided administrative and financial managerial duties for accounts payable finance department in corporate.
Maintained data management system, planned and coordinated department's entire administrative functions.
Prepared and participated in quarterly and yearly audits.
Analyzed business performance data and forecasted business results for upper management.
Managed departmental budgets and collaborated with procurement to secure and negotiate contracts.
Inspected staff completed work to drive quality, timeliness and company standards.
Supervised and delegated work to staff, setting priorities, goals and expectations.
Partnered with IT to design, develop and implement technology-based solutions.
Proactively resolved client issues pertaining to information not received; provided IT support for clients and staff users by trouble shooting online login and reports; Installed programs and performed configurations.
Led project scope development to deliver final products that meet business needs.
Developed business plans to incorporate growth, modernization and cost structure improvement.
Processed payroll bi-weekly, approve disbursements and tracked amortization schedules for vendor contact agreements.
12/2009 to 07/2013
Unit Compliance ManagerFranklin Hospital, North Shore LIJ Health System – City, STATE,
Provided regulatory oversight and corporate compliance implementation of policies and procedures, as unit's compliance manager.
Developed Code of Conduct and policies according to DOJ guideline.
Identified risks and/ or violations and conducted investigations.
Managed patient's health insurance, approvals, Medicaid and Medicare authorizations and electronic medical records in databases, as per HIPAA guidelines.
Provided HIPAA (Health Insurance Accountability Act) and NYDOH (New York Department of Health) regulations training to employees.
Oversaw patient's lab work entered by staff, answered phone calls, fax, created requisitions and order supplies.
Discussed health insurance, compliance risks and assessments with clinical staff and technicians, to ensure hospital compliance procedures and guidelines were being followed.
Oversaw patient's charts were organized, updated with correct information and ICD 9-10 (International Classification of Diseases) coding, for insurance carrier billing and compliance regulations.
Communicated interdepartmentally to establish coordination in administrative work and served as liaison between departments.
Participated and prepared for quarterly and yearly audits with state regulators and agencies.
Executed successful compliance monitoring and risk assessment programs.
Built and strengthened relationships with regulatory representatives, vendors and health insurance carriers.
Supported strategic development and objective setting by analyzing audit outcomes and generating actionable recommendations.
Contributed to large-scale risk assessment initiatives and promoted improved business procedures and controls.
Verified compliance for deliverables according to contract requirements.
Identified processes and policy gaps and devised solutions for regulatory requirements.
Education and Training
Expected in to to
Master of Studies in Law: Law in Corporate Compliance Fordham Law School - New York, NY, GPA:
Expected in to to
Bachelor of Arts: Forensic Psychology John Jay College of Criminal Justice - New York, NY, GPA:
Additional Information
COMMUNITY ENGAGEMENT
, North Shore LIJ Health System Diversity and Health Quality Lead
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