Managed Care

Need recommendation

  • 1.  Need recommendation

    Posted 06-18-2014 12:37 PM
    All -
    Can any of you recommend a consultant that will look at the Compliance function of an entire organization? I'm not looking for risk assessments or audits - I'm looking for consultant to look at structure of compliance staff, job descriptions, FTE's, communication processes etc. Goal is to assess current structure and compare it to all the functions regulators expect health plans to comply with and make recommendations for a company the size we are - best practices, FTE minimums, synergies with current job descriptions etc. 

    Janice Kennedy CHPC
    Compliance & Privacy Officer
    Senior Whole Health
    2020 HCCA Managed Care

  • 2.  RE: Need recommendation

    Posted 06-20-2014 12:55 PM

    Hi Janice,

    In response to your post, I wanted to pass along the name of a consultant we used for a similar exercise for our health system. Bob Hussar, who now works at Manatt, Phelps & Phillips is a former Compliance Officer. He also previously served as the First Deputy Inspector General at the NYS Office of the Medicaid Inspector General where he was responsible for rolling out the first Medicaid mandatory compliance programs in the country. He is also a board member of HCCA. He specializes in this area and I can tell you our BOD and senior management were very impressed with his review of our system.

     Bob can be reached at<> or at (518) 431-6730. Hope this helps and good luck with your project.

    Maggie Hall CHC
    Compliance Associate
    St. Joseph's Hospital Health Center

    2020 HCCA Managed Care