Compliance & Employee Relations Investigator

Job Description

Job Description

Overview:

Join us and be part of a mission-driven team that prioritizes innovation, collaboration, and continuous development. The Compliance and Employee Relations Investigator is responsible for conducting thorough, impartial, and timely investigations into allegations of employee conduct and behaviors, misconduct, policy violations, and regulatory non-compliance within a healthcare setting. This role ensures adherence to federal and state laws, internal policies, and ethical standards, while fostering a fair and respectful workplace culture.

Key Responsibilities:

1. Investigations
   1. Conduct timely, thorough, objective and confidential investigations including but not limited to employee complaints, including harassment, discrimination, retaliation, workplace violence, and other policy violations.
   2. Investigate compliance-related concerns including but not limited to those involving HIPAA, billing/coding practices, conflicts of interest, vendor misconduct, patient safety, and other healthcare regulations.
   3. Participate in investigations related to Information Systems violations.
   4. Interview complainants, respondents, and witnesses; gather and analyze relevant documentation and evidence.

1. Document all investigative steps, findings, witness interviews, and evidence in a clear and consistent manner.
2. Maintain detailed, accurate, and objective investigation records and reports.
3. Participate in root cause analyses and case conference reviews as appropriate.

1. Compliance Monitoring
2. Collaborate with the Compliance to ensure adherence to healthcare laws, regulations, and requirements (e.g., HIPAA, NY Shield Act, Stark Law, Anti-Kickback Statute, False Claims Act, 42CFR Part 2, NYS Article 28, HRSA).
3. Identify trends and recommend corrective actions or policy changes to mitigate risk.
4. Responsible for delivery, and maintenance of organizational training mandated by federal and state regulations.
5. Maintain awareness of current healthcare compliance laws, regulations, requirements and best practices.
6. Assist in responding to government inquiries, audits, or enforcement actions, as needed.

1. Employee Relations
2. Partner with the appropriate People Operations leader and involved department leadership in discussing investigation findings and resolution.
3. Support the development, review and implementation of training programs including but not limited to those related to compliance, ethics, and workplace conduct.

1. Reporting & Documentation
   1. Prepare unbiased written investigation summaries and findings for internal stakeholders and regulatory bodies as needed that include recommendations for corrective actions, policy revisions, or staff training.
   2. Maintain documentation electronically in a timely and organized manner utilizing the appropriate reporting system or other electronic file.
   3. Track and report on investigation outcomes, trends and corrective action plans to closure to support continuous improvement.

1. Legal
   1. Participate in legal, regulatory and insurance cases as required

Required Key Skills and Qualifications:

• Bachelor’s Degree in Human Resources, Healthcare Administration, Law or other relevant field preferred plus 5 years’ experience in compliance, employee relations, workplace investigations or as a paralegal; or
• Minimum of an associate’s degree plus 10 years’ experience required in Human Resources, Healthcare Administration or other relevant field including at least 5 years’ experience in compliance, employee relations workplace investigations or as a paralegal.
• Requires a strong knowledge of employment law, healthcare regulations, and investigative procedures.
• Experience in healthcare compliance, auditing, legal investigations, or regulatory enforcement.
• Experience in the non-profit healthcare industry is a plus.
• Requires a valid NYS Driver License, car and specified insurance coverage to be able travel to various locations.

Preferred Certifications

• Certified in Healthcare Compliance (CHC)
• Professional in Human Resources (PHR/SPHR)
• Association of Workplace Investigators (AWI-CH)

Competencies

• Excellent interpersonal, interviewing, investigative and analytical skills.
• High level of integrity, discretion and professionalism in handling confidential information.
• Skilled in problem-solving, critical thinking, applying sound judgment and attention to detail
• Ability to manage multiple investigations simultaneously and meet deadlines.
• Ability to maintain neutrality.
• Exceptional written and verbal communication and report-writing abilities.
• Knowledge of trauma-informed investigation practices is a plus.
• Proficiency in Office 365 and electronic reporting systems.

Miscellaneous

• Requires the ability and commitment to respect and support patients, other employees and visitors with various lived experiences.
• Requires individual demonstration of commitment to the mission, vision, One Trillium values, behaviors and modeling them in the organization.
• Responsible for maintaining confidentiality of all patient, client, employee, protected and proprietary information.
• Employees are accountable for meeting the performance standards of their departments and must participate as requested in compliance audits and quality improvement plans.
• Required to participate in continuous improvement of job responsibilities and organizational or work processes to advance the organization or department.
• Other specific duties as assigned.

Physical and Mental Requirements

• Ability to sit/stand for extended periods at a desk and work on a computer.
• Ability to move within an office environment.
• Manual dexterity to operate a computer keyboard, mouse, and other office equipment.
• Visual acuity for reading documents, spreadsheets, and computer screens at close range.
• Ability to lift and carry office supplies or files up to 15 lbs