Legal Operations and Compliance Administrator

The Legal Operations Compliance Administrator is responsible for performing legal and compliance management-related duties with minimal supervision. Responsibilities include: leading contract lifecycle management function and system, managing responses to both standard and complex medical record requests and subpoenas as the PPGT legal record custodian, directing mitigation of organizational risk in conjunction with Risk and Quality Management (RQM) leadership, and managing Vendor Risk Assessment (VRA) lifecycle management across the organization. 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.

Legal Operations:

• Manages various legal and organization documents, contracts, correspondence, and other compliance matters including managing document collection and distribution for litigation requirements and related internal document management.
• Medical Records Requests and legal document management:

o As Record Custodian, manages the organization’s responses to medical record requests in collaboration with Risk and Quality Management (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. This includes managing the processing, transfer and security of patient data within PPGT to ensure that the data collected for record subpoenas and other requests is securely collected and delivered as well as ensuring compliance with applicable HIPAA regulations and other health information management standards.
o Provides quality control for legal documents, tracks matter progress, and facilitates adherence to mandated litigation or regulatory content and timelines.
o May lead or participate in projects, serving as a resource and subject matter expert for internal teams on legal and transactional matters.
o As applicable, manage due diligence for related legal matters, including litigation and transactional matters, by managing organizational documents, while addressing any issues and ensuring compliance with legal requirements and due diligence requests and responses.

• Contract Management:

o Leads the contract lifecycle management workflow using iManage contract management system.
o Develops and manages internal processes that assure the accuracy and integrity of data entered into the contract management system in adherence to system requirements based on 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 BAA’s 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 Develops and maintains system tools and processes that provide timely notification of critical contract events (e.g., renewals, termination, and due dates contained within the agreements) and initiation of related system actions.

• 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 Leads integration of VRA review and requirements to integrate population of applicable management contracting components including processes that provide timely notification of critical events (e.g., renewals, termination, and due dates contained within the agreements and cyclical VRA updates) as housed in management.
Compliance Operations:

• Partners with Risk and Quality management leadership to understand and mitigate risk to the organization. Conducts research and coordinates actions with GC/CCO.
• 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 their management of efforts to prevent, detect and correct occurrences of healthcare fraud and abuse.
• Manages and develops resources for assigned workgroups, task forces or committees that support improvement of the affiliate’s board initiatives assigned to Legal and Compliance through the development and application of applicable tools, responsible for analysis and maintenance of data collection.
• Liaison to GC/CCO to oversee and administer the process of self-reporting to government agencies when appropriate and necessary.
• Aid and work with risk assessment project teams as needed for quick response to cross-departmental high-risk issues.

General expectations:

• 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 exempt experience or Associate’s degree + 5 years of relevant exempt experience or H/S diploma (or equivalent) + 7 years of relevant exempt experience. Relevant exempt experience: healthcare compliance management, legal, risk and quality management or related exempt experience. Healthcare industry experience preferred.

Healthcare Compliance or Paralegal certification preferred. Notary preferred.

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.

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.