Week 4 Assignment: The Role of a Compliance Officer

For this assignment, you will discuss and explain the role of a healthcare compliance officer.

All healthcare organizations are required to have a healthcare compliance officer. Larger healthcare systems will have an entire department devoted to healthcare compliance. Smaller organizations may designate the administrator, the director of Health Information Management (HIM), or the business office manager as the organizational compliance officer. All health plans have a robust compliance department. Using the course resources as well as conducting your own independent research to address the following:

·         Identify and explain the functions of a health care compliance officer.

·         Investigate the background and credentials required to be a compliance officer.

·         Determine the reporting structure for compliance officers.

·         Identify and discuss situations when direction from a compliance officer is required.

·         Analyze possible interactions that a compliance officer would have in auditing, evaluating risk for fraud, and managing and reporting compliance problems.

·         Identify specific areas of concern for fraud and abuse in healthcare organizations.

·         Analyze the impact of the way regulations have increased the need for compliance officers and compliance programs.

·         Evaluate how the compliance officer would manage the specific topic that you are using for your project topic in class.

·         Write clearly and logically with the correct use of spelling, grammar, and APA style and formatting.

Additional Requirements

Length: A minimum of 5–7 double-spaced pages, not including title and reference pages. Title pages and reference pages do not count in the page count of a paper. Avoid direct quotes.

·         This paper should have an introductory paragraph to introduce the chosen topic.

·         The paper should include salient points related to the topic choice.

Font: Times New Roman 12-point.

References: Cite at least five references from peer-reviewed journals and/or course resources.

Format: Use current APA style and formatting. See APA ModuleLinks to an external site.

Grading Guidelines / Assignment Requirements

1.      Identify and explain the functions of a healthcare compliance officer.

v  Your paper MUST Identify and explain the functions of a healthcare compliance officer. providing the value added by the compliance officer.

2.      Investigate the background and credentials required to be a compliance officer.

v  Your paper MUST Investigate the background and provide a detailed explanation of the credentials required to be a compliance officer.

3.      Determine the reporting structure for compliance officers.

v  Your paper MUST Determine and explain the reporting structure for compliance officers.

4.      Identify and discuss situations when direction from a compliance officer is required.

v  Your paper MUST Identify, discuss, and analyze situations when direction from a compliance officer is required.

5.      Analyze possible interactions that a compliance officer would have in auditing, evaluating risk for fraud, and managing and reporting compliance problems.

v  Your paper MUST Provide a detailed analysis of possible interactions that a compliance officer would have in auditing, evaluating risk for fraud, and managing and reporting compliance problems.

6.      Identify specific areas of concern for fraud and abuse in healthcare organizations.

v  Your paper MUST Identify specific areas of concern for fraud and abuse in healthcare organizations, strengthening your position with examples.

7.      Analyze the impact of the way regulations have increased the need for compliance officers and compliance programs.

v  Your paper MUST Analyze the impact of the way regulations have increased the need for compliance officers and compliance programs, providing examples from the readings.

8.      Write clearly and logically with correct use of spelling, grammar, and APA style and formatting.

Your Paper MUST be written clearly and logically, using evidence to support a central idea, with exemplary use of spelling, grammar, punctuation, and APA style and formatting.