Healthcare Compliance Resume Sample

4.9
8 votes
Adrian Hudson
7923 Pfannerstill Summit,  Phoenix, AZ
+1 (555) 169 6031

Work Experience


Healthcare Compliance Specialist
05/2016 - PRESENT
Boston, MA
  • Oversee Work-plan-related inter-dependencies toward the goal of ensuring timelines, quality and partnership. Support communication of Work-plan updates to Board of Directors’ and Management Compliance Committees
  • Identify areas of risk at Mallinckrodt and manage and assist in the development of risk mitigation plans to help build upon our Company’s culture of compliance
  • Play a key role in the development and implementation of the CBMI HCC program, working cross-functionally within the company and with key divisions of CBMI’s parent company and affiliates
  • Draft policies, procedures and work instructions for CBMI as necessary to implement its HCC program.
  • Provide day-to-day compliance guidance and advice to business partners, working with legal, corporate compliance and regulatory colleagues as necessary.
  • Assess training needs, develop training programs, and evaluate programs’ effectiveness solutions to meet compliance requirements
  • Familiarity with US and international anti-corruption laws and regulations
  • Familiarity with US healthcare compliance laws and regulations
  • Exposure to US and international sales operations
Healthcare Compliance Specalist
02/2012 - 11/2015
Detroit, MI
  • Review and, where appropriate, act in response to reports of noncompliance. This includes taking a leading role in establishing and implementing remedial activities for specific local HCC audit findings or other potential risk areas and interacting and following through with applicable departments and functional heads for corrective actions, preventive actions and implementation
  • Act as key contact for local HCC Audit: provide advanced information, prepare documentation, identify local functions/team members
  • Act as key contact point for global compliance for activities in the scope of HCC. This includes local self-inspections and the review and translation (if applicable) of Corporate Policies, Regional Template SOPs, presentations, communications and trainings
  • Represent local HCC on global, international or regional cross-functions teams (including EMEA HCC Forum)
  • Demonstrable experience in a Senior Healthcare Compliance role incorporating experience across the essential areas of the compliance and the ABPI and IPHA code of practice
  • Build excellent knowledge of and network within Boehringer Ingelheim
  • Experience using Zinc
  • ABPI Code training to certifier level or equivalent
Student Internship Finance Healthcare Compliance
12/2007 - 09/2011
Philadelphia, PA
  • Analyze data for patterns and inconsistencies
  • Communicate effectively at all levels of the organization and with partners around the globe
  • Plan, design, operationalize, monitor and oversee the local Healthcare Compliance (“HCC”) program to ensure local compliance with applicable internal and external rules and regulations (e.g., local Code, Corporate Policies, local specific legislation)
  • Report on a regular basis to the local Management Team on compliance matters and assisting the General Manager/Country Manager and the Management Team’s members to establish appropriate methods to reduce the company’s healthcare compliance risks
  • Work in close cooperation with the General Manager / Country Manager to create a culture of compliance and set the tone at the top. This includes promote open communication and dialogues where staff members feel comfortable speaking up
  • Provide an overview of the local compliance status to global Compliance (as appropriate)
  • Periodically review the local HCC program, as appropriate, to respond to changes in the company’s needs and applicable local and global requirements, identified weakness in the program, or identified systemic patterns of noncompliance
  • Develop, coordinate, and participating in a multifaceted educational and training program that focuses on the elements of the compliance program, and seeking to ensure that all affected employees and management understand and comply with pertinent standards

Education


Herzing University Madison
2001 - 2006
Bachelor's Degree in Healthcare

Professional Skills


  • Advanced verbal and written communication skills including documentation of data gathering interviews, familiarity with process controls documentation, audit or gap assessment findings and recommendations
  • Demonstrate strong communication, interpersonal, analytical, writing, presentation, self-motivation, broad thinking, and business skills
  • Strong problem solving, conflict management and consensus building skills
  • Has impeccable ethics. Demonstrates, or has proven abilities to demonstrate Roche Values and Leadership Commitments
  • Excellent PC skills (Excel, Word, Sharepoint)
  • Skills in developing and nurturing cooperative relationships with varying stakeholders
  • Utilize effective communication and problem solving skills to efficiently identify issues, concerns and interests and provide effective solutions

How to write Healthcare Compliance Resume

Healthcare Compliance role is responsible for security, software, finance, training, database, recruiting, auditing, reporting, manufacturing, design.
To write great resume for healthcare compliance job, your resume must include:

  • Your contact information
  • Work experience
  • Education
  • Skill listing

Contact Information For Healthcare Compliance Resume

The section contact information is important in your healthcare compliance resume. The recruiter has to be able to contact you ASAP if they like to offer you the job. This is why you need to provide your:

  • First and last name
  • Email
  • Telephone number

Work Experience in Your Healthcare Compliance Resume

The section work experience is an essential part of your healthcare compliance resume. It’s the one thing the recruiter really cares about and pays the most attention to.
This section, however, is not just a list of your previous healthcare compliance responsibilities. It's meant to present you as a wholesome candidate by showcasing your relevant accomplishments and should be tailored specifically to the particular healthcare compliance position you're applying to. The work experience section should be the detailed summary of your latest 3 or 4 positions. Representative Healthcare Compliance resume experience can include:

  • Ensures team has successfully completed Good Manufacturing Practices training
  • Attending industry conferences to represent the firm, understand the marketplace, and network with perspective clients
  • Carrying out day-to-day tasks such as data collection, analysis and reporting,
  • Develop and conduct ongoing monitoring of client activities, events and programs
  • Assists in coordinating document and data control (e.g., numbering, version control, controlled copies, etc.)
  • Assist in the implementing and following up on the Management Action Plan as assigned by the HCC Officer

Education on a Healthcare Compliance Resume

Make sure to make education a priority on your healthcare compliance resume. If you’ve been working for a few years and have a few solid positions to show, put your education after your healthcare compliance experience. For example, if you have a Ph.D in Neuroscience and a Master's in the same sphere, just list your Ph.D. Besides the doctorate, Master’s degrees go next, followed by Bachelor’s and finally, Associate’s degree.

Additional details to include:

  • School you graduated from
  • Major/ minor
  • Year of graduation
  • Location of school
These are the four additional pieces of information you should mention when listing your education on your resume.

Professional Skills in Healthcare Compliance Resume

When listing skills on your healthcare compliance resume, remember always to be honest about your level of ability. Include the Skills section after experience. Present the most important skills in your resume, there's a list of typical healthcare compliance skills:

  • Good negotiation skills: can effectively drive discussions and decisions toward desired end-results
  • Build strong credibility at local, regional and global level, to effectively interact, providing direction, challenge and support whenever relevant
  • Support the implementation of local testing & monitoring plan to demonstrate that the HCC program is effective and participate in execution where appropriate
  • Track, prioritize, and execute on multiple and frequently changing priorities is required
  • Deep CMS regulatory knowledge, including Medicare Advantage Chapter 21/9 experience
  • Strong knowledge of the commercial insurance industry products including ACA, fully and self- insured products and services

List of Typical Experience For a Healthcare Compliance Resume

1

Experience For Healthcare Compliance Specialist Resume

  • Effectively integrates compliance risk/context and business knowledge to address complex problems. Keeps current in the area of privacy regulations and laws
  • Perform audits, interview clients, gather evidence, and document results into work papers
  • Enters and maintains data, information, documents and files according to standards, including but not limited to compliance software
  • Knowledge of medical auditing and ICD-10, CPT, HCSPCS, DRG coding
  • Accountable for overseeing or completing department corrective actions or actions of others
  • Verifiably tenured in conducting and managing PCI compliance programs
2

Experience For Healthcare Compliance Manager Resume

  • Adequate roll-out, implementation and training of HC standards and processes, appropriate tailoring to stakeholder groups
  • Support Implementation of Cluster strategy & plan aligning with the businesses and J&J Office of Compliance
  • Conducts research and analysis of coding and regulatory requirements with respect to revenue cycle and other functions as requested
  • Knowledge of Medicare regulations and policies including Part A and Part B
  • Partner with selected commercial and medical teams as required to setting up strategies and tactics under consideration of all relevant HC regulations
  • Proper etiquette including customer relation techniques, superior verbal and
  • Ensure quality and compliance in Roche’s collaboration with external healthcare professionals
3

Experience For Senior Analyst, Healthcare Compliance Resume

  • Country Requirements - Analyse, review with country / regional lead and feed new or revised requirements to technical teams (including requirements, existing system landscape, gap analysis, plan of action to minimize impact on business, data collection & tools)
  • Support: Manage disclosure support mailbox, action / escalate as required; point of contact for country user/super-users
  • Continuous improvement – conducts feedback surveys/ reviews & creates plans/tracking for implementation of continuous improvements related to Automation & Disclosure
  • Quality checks - Design, maintain and continuously improve quality checklists and associated training; Maintain overview of completion, analyse & communicate outcomes
  • Disclosure Report Publication - Maintain / update Methodological Note; monitor timely report publication; coordination of visitor tracking with web team; co-ordination of Patient Organisation disclosure reporting; co-ordination of the publication of disclosure reports with the Amgen web team
  • Establish a strong and visible compliance presence with the client's organizations
  • Provide timely and appropriate responses to client requests and inquiries
4

Experience For Director Commercial Healthcare Compliance Resume

  • Leading the HCC Monitoring activities to ensure effective identification of warning signals and/or gaps and provide meaningful feedback to franchise leaders so that appropriate corrective actions are taken
  • Lead activities related to Audits (internal, Medical Technology Association of Australia or Medicines Australia)
  • Lead HCC activities related to company Acquisitions
  • Implement Management Action Plans and escalation process for serious allegations
  • Primary task: supporting the implementation of operational compliance requirements (EFPIA): processing and acquisition of data sets for a central information system
  • With regards to Transparency
  • Ensures team is adequately trained on corporate and client-specific procedures
5

Experience For Senior Director Healthcare Compliance Americas Resume

  • Generates, reviews and approves documentation and reports to support client products
  • Conducts policy and procedure reviews with clients to determine specialized requirements
  • Prepares and distributes internal audit reports and findings to track and trend audit results; initiates corrective and preventative action
  • Supervises the hold/release process to ensure appropriate product releases
  • Conducts random accuracy checks of inbound receipt put-aways
  • Documents specific and accurate information; learns subjects thoroughly and in detail; completes work with thoroughness; maintains organized files
6

Experience For Senior Healthcare Compliance Analyst Resume

  • Demonstrates basic understanding of the functions, regulations and procedures of compliance agencies or governing bodies; takes leadership position in programs that reduce risk and enhance safety
  • Expresses ideas clearly and concisely
  • Work within the Healthcare Compliance team to review functional processes and procedures to facilitate positive change
  • Identify areas for refinement and development for Code-related policies and procedures in line with business goals
  • Provide management information on Code compliance
7

Experience For Director, Healthcare Compliance, Americas Resume

  • Assist in implementation of modifying regional global strategies into regional and local level and where needed sector level, based on appropriate local needs, goals and objectives, taken into account local external regulatory trends and environment
  • Support the HCC operations group in implementation of education, training, and regular communications on HCC to all covered employees, including local sales, marketing, finance, HR, managers, supply chain and directors at the local level
  • Report unplanned deviations and supporting the HCC Officer in Managing day-to-day inquiries, allegations and investigations
  • Implement the escalation process for serious allegations, as appropriate
  • Collect and Provide metrics to the HCC Officer and Operations group as assigned
8

Experience For Senior Director, Healthcare Compliance Resume

  • Liaise with legal department and external advisors
  • Lead HCC projects and participate in regional or cross-sector projects
  • Participate in bigger projects
  • Facilitates regulatory based audits and assessments to include scheduling, coordination, internal notification, scope determination and continued oversight through closure
  • Provides communication of audit results to departments/functions, leadership and Board level committees
9

Experience For Healthcare Compliance & Quality Associate Manager Resume

  • Maintains the compliance audit program, including schedules, standards, processes, reports and tools in close collaboration with the System Director of Compliance
  • Proactively research, evaluate and make recommendations associated with evolving privacy laws and regulations. Benchmarks and stays abreast of other industry and marketplace developments and best practices
  • Contribute to annual HCO Work Plan development and implementation and contribute to ongoing continuous improvement
  • Proactively identifies and addresses compliance issues and risks
  • Recommends and drafts new or amended privacy policies and/or SOPs while specifying actual or potential implications to existing business operations, procedures and practices
  • Leads and/or participates, with limited direction, internal committees or is lead reviewer in a complex process
10

Experience For Global Healthcare Compliance Specialist Resume

  • Helps others apply policies and SOPs correctly. Trains and communicates to others on privacy policies and SOPs
  • Oversees department’s activities with respect to federal and state privacy requirements
  • Monitors/Assess compliance of programs and vendors to HCO policy and SOP requirements
  • Prepares regular reports for management and cross functional teams
  • Where applicable, manages outside vendors to ensure on-time, on-target and within-budget deliverables
  • Respond to and advise on healthcare compliance questions in collaboration with the HCO’s overall Training & Support team and identify specific needs regarding HC specific training, standards or procedures in Global Functions

List of Typical Skills For a Healthcare Compliance Resume

1

Skills For Healthcare Compliance Specialist Resume

  • Good to excellent Excel and MS Office skills
  • Excellent organizational and planning skills as well as the ability to handle multiple tasks simultaneously
  • Good business acumen: understands how the business “works” and demonstrates consistently effective “navigation” across the organization
  • Thinks “outside of the box” for solutions. Applies creative problem solving and appropriate business solutions to effectively address compliance risk
  • Ethical, with a strong understanding of compliance risks and a good sense for practical solutions
  • Skills to work under minimal supervision in accomplishing assigned responsibilities
  • Interact effectively with associates at all levels in all departments
2

Skills For Healthcare Compliance Manager Resume

  • Communicate clearly, concisely and effectively
  • Listen carefully and effectively communicate complex topics with different types of potential clients
  • Demonstrates good knowledge of computerized customer database with proficiencies in Microsoft Excel, Word and PowerPoint
  • Skills to function with the highest sense of integrity, exercising unprejudiced and unbiased judgment on behalf of Ochsner Health System's welfare
  • Knowledge and relevant experience in one or more of the following areas
  • Demonstrated ability to build alignment, influence, execute all levels of the organization
  • Experience with healthcare corporate compliance issues
  • Experience in one of the following areas: Legal, Regulatory Affairs, Finance, Health Care Compliance
3

Skills For Senior Analyst, Healthcare Compliance Resume

  • Demonstrated ability to quickly establish trust and rapport with other personnel
  • Previous experience within a Commercial environment, ideally within a large multi-national matrix environment
  • Attention to detail , strong sense of responsibility
  • Work experience in privacy
  • Ensure systems, policies and processes are effective and efficient
  • Organizing and implementing training on HCBI and HCC Local regulation (D.Lgs. 231/01)
4

Skills For Director Commercial Healthcare Compliance Resume

  • Working knowledge of program and process implementation / administration and policy development
  • Implementing change within the UK and Irish businesses to ensure compliance as mandated by internal, external or legal requirements
  • Developing & reporting metrics
  • Understanding of business process, business acumen
  • Assist in the harmonization, preparation, updating and implementation of all HCC written policies and procedures on an ongoing basis,
  • Represent HCC in Country Value Teams/marketing planning meetings
  • Work with multiple clients, multi-tasking with clients and engagements
  • Collect or coordinate collection of necessary documentation, including policies, emails, agreements, etc
  • Review and approval of engagements and meetings with HCPs and funding provided to HCOs
5

Skills For Senior Director Healthcare Compliance Americas Resume

  • Develop strategy, content and conduct compliance training for client groups
  • Assists in interpreting regulations and procedures for clients to facilitate compliance
  • Supports implementation of training programs and materials
  • Communicates quality assurance methodology and explains desired outcomes of testing; identifies steps in project lifecycle
  • Provides colleagues with advice/guidance and training on local UK healthcare legislation and policy
  • Develop and conduct training for internal and external parties
  • In-depth knowledge of Medicaid and Medicare Advantage operational processes, FDR’s and program audit and universe development
  • Strong influencing skills: proven track record and experience building and cultivating relationships with key partners and stakeholders across organizational levels
  • Good verbal and written business communication skills: highly adept at synthesizing and summarizing complex and/or voluminous content into clear, concise and actionable communications
6

Skills For Senior Healthcare Compliance Analyst Resume

  • Good process-orientation: has proven effectiveness in identifying, developing and implementing scalable/sustainable process and other continuous improvements to achieve organizational efficiencies and increase effectiveness
  • Good project management skills: can prioritize multiple tasks and goals to ensure timely, on-target and within-budget accomplishment of such
  • Pursues self-development, which is comprised of internal, external and self-administered curriculum, as well as regular reading of applicable journals, periodicals and publications
  • Supports in-services and other educational services to organization, management, and employees regarding risks, controls and compliance-related matters
  • Maintains technical compliance regulatory knowledge and acts as a resource for the organization, management, and employees
  • Revenue Integrity, Provider Integrity, Clinical Regulatory Response, Tax Exempt Compliance, Research Integrity, Data Integrity, including HIPAA Privacy and Security or Overall Corporate Compliance Program Administration
  • Thorough understanding and knowledge of healthcare, legal and regulatory practices
  • Sense of honesty, integrity and caring with the ability to inspire and motivate others to promote the philosophy, mission, vision, goals and values of Ochsner Health System
7

Skills For Director, Healthcare Compliance, Americas Resume

  • Inspire and motivate, promoting open communication and foster teamwork
  • Effective communication at all times. Experience in delivering complex messages, in a matrix organization, to a diverse audience with a track record of effective and influential presentations
  • Extensive knowledge and understanding of applicable HCC laws and guidance, including but not limited to OIG guidelines, AMA guidelines, PhRMA Code, Corporate Integrity Agreements, Anti-Kickback, False Claims Act, Spend Transparency
  • Advanced computer skills and proficiency in MS Word, Excel, Access, PowerPoint, and Outlook required
  • Previous experience in a healthcare setting with overall responsibility for regulatory compliance, auditing or similar role
  • Knowledge of applicable regulations, standards and licensing requirements governing the healthcare industry
8

Skills For Senior Director, Healthcare Compliance Resume

  • Knowledge of regulatory requirements and industry standards (HITRUST, HIPAA Security Rule, PCI)
  • Familiarity with Wisconsin's managed care environment, Dean Health Plan products, the Affordable Care Act and/or the HIPAA Privacy Rule
  • Able to draft insurance policy/benefit language, corporate policies and procedures and proposed legislation
  • CHC, CHPC, CHRC, or CPC
  • Prepare and present complex and multifaceted reports to various audiences
9

Skills For Healthcare Compliance & Quality Associate Manager Resume

  • Experience with regulatory compliance requirements pertaining to healthcare provider industries, including compliance requirements for pharmacies and healthcare units
  • Experience identifying, analyzing and prioritizing compliance based risk and determining potential impact to an organization
  • Experience driving change and growth in a business, including working with a corporate management team contributing to company-wide strategy and implementation
  • Experience establishing and communicating compliance procedures and policies pertaining to pharmacy and healthcare
  • Experience designing, implementing and enforcing a compliance function to ensure the organization’s policies and applicable laws and regulations are adhered to
  • Experience with Federal Sentencing Guidelines, OIG’s Seven Elements of an effective compliance program and regulatory requirements related to pharmacy and healthcare requirements
  • Experience navigating an organization through a regulator audit, including writing responses to regulators, drafting corrective action plans (CAPs) and/or assessing effectiveness of corrective actions
10

Skills For Global Healthcare Compliance Specialist Resume

  • Experience formulating and communicating a strategic vision for compliance and leading strategic projects and initiatives relating to the compliance function
  • Experience establishing and developing an annual compliance plan, including compliance training and oversight activities
  • Experience managing and conducting annual and periodic compliance assessments and leading the implementation of post-audit and/or monitoring recommendations
  • Experience simplifying and communicating compliance guidance and articulating potential issues /problems to all levels of an organization, experience presenting to senior management, and/or Audit Committees / Boards
  • Leadership and coaching skills; team-building abilities
  • Experience directly managing people, including hiring, developing, motivating, and directing people as they work
  • Efficient at handling and prioritizing multiple projects in a service-oriented environment

List of Typical Responsibilities For a Healthcare Compliance Resume

1

Responsibilities For Healthcare Compliance Specialist Resume

  • Good understanding of planning processes to meet established timelines
  • Challenge status quo and to propose alternatives (critical thinking)
  • Improve working methods
  • Information technology risks, processes and controls
  • PCI DSS, SOX, SOC, HIPAA/HITRUST (ISO / NIST) compliance efforts
  • Key domains of information technology general controls, including change management, access to systems, networks and data, computer operations and systems development
  • Assist with the development of policies, procedures and standards that meet existing and newly developed policy and regulatory requirements including SOX, PCI,
  • Serve as project lead within IT security and GRC projects
  • Promote awareness of applicable regulatory standards, upstream risks and industry best practices across the enterprise
2

Responsibilities For Healthcare Compliance Manager Resume

  • Support global teams by responding to and advising on healthcare compliance related questions and identify needs regarding HC specific training, standards or procedures in Global Functions
  • Lead/contribute to the development and/or revision of policies, SOPs and other documentation as required
  • Identify potential synergies and/or opportunities for process improvements across the Pharma Division
  • Medical Devices or Pharma Background
  • Proactive, flexible, responsive and resourceful
  • Grasp best practices and use them to provide client solutions
  • Review and synthesize data into meaningful reports
3

Responsibilities For Senior Analyst, Healthcare Compliance Resume

  • Direct and practical experience with drafting policies, managing training programs and performing testing and monitoring activities, preferably in compliance or legal business function
  • Establishing policies and procedures to facilitate the company’s compliance with rules and regulations impacting the health and insurance industries, primarily HIPAA
  • Conducting complex investigations. Supporting external and corporate audits as required by the business developing and executing subsequent management action plans
  • Upholding responsibility for the maintenance of existing programs. Implementing and maintaining the on-going mandatory training program for business, reporting quarterly figures as required
  • Provide advice to clients on regulations and other actions by regulatory agencies, Medicare, Medicaid, OIG, OCR, DHHS, DES and other regulatory agencies
  • Consult with clients on changes in laws and regulations that might affect their organization
4

Responsibilities For Director Commercial Healthcare Compliance Resume

  • Meet deadlines and develop final documentation within tight timeframes
  • Role model for ethical behavior
  • Strong interpersonal skills to interact with individuals of diverse cultural backgrounds, of all ages, and at all levels within and outside the organization in a positive, effective manner
  • Communications and Training - Develops, maintains and implements communications and training on system solutions/enhancements & quality checks; manages training & assessment for HCR access requests & access deletions; conduct 3rd Party trainings (as necessary related to Disclosure & Automation) and/or follow up training was conducted by affiliate staff
  • Solid knowledge of special knowledge area and internal control structures (which includes compliance with applicable laws and regulations), business risk, effective risk management techniques and auditing, and compliance's role in corporate governance and it's key relationships with the audit committee, board, and executive and operating management
5

Responsibilities For Senior Director Healthcare Compliance Americas Resume

  • Skills to translate internal control objectives and complex laws and regulations into easily understood concepts, apply those concepts to a function or process, and teach/instruct others on these matters
  • Skills to gather information and understand problems, seeking out cause-and-effect relationships that identify underlying issues or problems which includes intermediate knowledge of interviewing skills and reading and comprehending complex documents
  • Strong HIPAA knowledge
  • Travel regionally to various sites
  • Knowledge of the FCPA and related regulations ideal
  • CHC, CIA, CPB or CPMA beneficial
6

Responsibilities For Senior Healthcare Compliance Analyst Resume

  • In a regulatory function
  • Healthcare Compliance Certification (before or w/in 6 months of appointment)
  • Fluency in spoken and written Spanish and/or Portugese
  • Certification Desired: CISSP
  • Subject matter knowledge

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