Job ID: IN-797081
Hybrid/Local COPA Consultant/Healthcare BA (CHC Certified) with Certificate of Public Advantage, regulatory, Compliance, Hospital Submissions/financials/Billing, metrics, Pricing, incident investigation experience
Location: Indianapolis, IN (Indiana Department of Health Office of Legal Affairs)
Duration: 9 Months
Skills:
Bachelor s degree in Healthcare Administration, Public Health, Business, or related field Required
Minimum 5 years of experience in hospital administration, compliance, or healthcare regulatory oversight. Required 5 Years
Proven ability to interpret contracts and structured compliance documents. Required 5 Years
Strong understanding of federal and state healthcare regulations. Required 5 Years
Master s degree in Healthcare Administration, Public Health, Business, or related field. Highly desired 5 Years
Certification in healthcare compliance (e.g., CHC Certified in Healthcare Compliance). Highly desired 5 Years
Familiarity with COPA frameworks or similar regulatory agreements. Highly desired 5 Years
Experience working with state health departments or healthcare regulatory agencies. Highly desired 5 Years
Required Qualifications
Bachelor s degree in Healthcare Administration, Public Health, Business, or related field (Master s preferred).
Minimum 5 years of experience in hospital administration, compliance, or healthcare regulatory oversight.
Strong understanding of federal and state healthcare regulations.
Proven ability to interpret contracts and structured compliance documents.
Skills and Competencies
Excellent verbal and written communication skills.
Strong project management and organizational abilities.
Proficiency in compliance monitoring, incident investigation, and regulatory reporting.
Advanced analytical skills and attention to detail.
High level of discretion in handling sensitive and confidential information.
Preferred Experience
Familiarity with COPA frameworks or similar regulatory agreements.
Experience working with state health departments or healthcare regulatory agencies.
Description:
The COPA Consultant will provide independent oversight and compliance review of the Terms and Conditions associated with a hospital s Certificate of Public Advantage (COPA).
This exception process was created in recognition for when there could be circumstances in which rate adjustment(s) may benefit the State.
Position Summary
The COPA Consultant will provide independent oversight and compliance review of the Terms and Conditions associated with a hospital s Certificate of Public Advantage (COPA). This role ensures transparency, accountability, and adherence to regulatory requirements, supporting the Department s mission to protect public health and maintain fair healthcare practices.
Key Responsibilities
Develop and Maintain Compliance Framework:
Design, implement, and refine a robust compliance monitoring system for COPA oversight.
Review and Analyze Hospital Submissions:
Assess documentation submitted by COPA recipient hospitals for compliance with COPA requirements, including:
Quality metric reporting
Hospital financial information
Billing compliance
Pricing as a percentage of Medicaid compliance
Commitments related to access to care, service enhancements, quality of care, and employment
Support Annual Reviews and Evaluations:
Assist the Department in conducting annual COPA reviews and overall evaluations in accordance with established Terms and Conditions.
Identify and Report Noncompliance:
Collaborate with the Department to determine potential noncompliance and recommend corrective actions.
Coordinate Information Requests:
Work with the Department and hospitals to obtain necessary records and documentation in a timely manner.
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