Carmella Miller

Experience

• 

  Holy Family Institute

  Jun 2010 - Aug 2012

  Chief Quality, Compliance, and Risk Officer

  • Advised CEO and Management team on all compliance-related matters• Incorporated new regulations into existing operations and ensured compliance• Developed and implemented HIPAA policies• Executed process improvement activities, based upon quality and risk data• Updated and managed system-wide chart review process for all service lines• Facilitated quarterly quality and risk meetings• Established new procedures for exclusion screening • Created and conducted waste, fraud, and abuse trainings• Successfully led the organization through Council on Accreditation (COA) re-accreditation Show less

• 

  UPMC

  Aug 2012 - now

  Compliance Manager

  • Review new/upcoming regulations, determine the relevance to current business lines, and assist in implementing new processes to ensure compliance• Analyze existing practices for efficiency and compliance with regulations and standard operating procedures• Assess auditor/payer compliance with regulatory requirements• Evaluate business activities to assess compliance risk• Conduct root causes analyses on audit-related identified issues and implement improvements as needed• Perform internet research on regulatory issues in response to specific questions from Revenue Cycle Management team• Advise on modifications needed to Corporate Care Management policies, procedures, and associated forms• Regularly present current compliance-related topics to hospital Medical Directors and Care Management Directors• Act as Privacy Officer for Revenue Cycle staff• Function as subject matter expert to the organization for compliance-related Corporate Care Management issues• Assist in integration of new hospitals into the UPMC health system• Promote compliance awareness throughout Revenue Cycle• Led project to examine and modify readmission process for the entire hospital system Show less