Maintaining a Culture of Compliance in a Remote Environment

Here’s how to create and maintain a culture of compliance.

Rachel Reimann, Compliance Officer and Administrator at Select Health.

Compliance is essential to building a strong business foundation. At its core, compliance is defined as the act of abiding by a set of policies and procedures that have been established by an organization and at federal and state levels. Simply put, it is the act of doing the right thing in accordance to the law. Compliance is often coupled with ethics, and while each of these components work hand-in-hand, they have their own missions. Ethics is doing the right thing regardless of whether there is a legal requirement attached. These elements help build a strong culture and can even boost employee morale if correctly implemented and properly maintained.

Compliance touches every department in an organization. Employees and teams cannot be successful in their roles without a culture of compliance. Compliance is not an initiative by one department—it is the backbone of what the organization does and how it is done. It is ongoing. A culture of compliance is ultimately the culture of the organization.

In health insurance, compliance helps us stay consistent with regulations that have been outlined for our industry. The Select Health Compliance team investigates issues of potential noncompliance including fraud, waste, and abuse. Additionally, we provide education and work to promote and enforce the Select Health code of conduct. It is our way of ensuring our organization and caregivers remain compliant and that we are protecting our members by preventing and detecting related issues.

Compliance also provides a lens through which employees can filter decisions and guides how they should act and engage with internal and external clients. It also provides structure for the creation and assessment of processes and procedures.

Creating a culture of compliance

There are several risks of noncompliance: fines, inability to sell products or services, and program suspension. It is important for organizations to remain complaint. To do so, an organization needs to implement an effective compliance program. This program should strive to foster a culture of ethical behavior with all regulations and organizational standards and give employees a strong foundation upon which to act. Regulations and the degree to which an organization is regulated may differ from industry to industry, but the elements of a program are universal. Here are the seven key elements that create a successful compliance program:

  • Standard policies and procedures that guide employees and set clear expectations
  • Education and training on regulations and organization standards
  • Oversight
  • Monitoring and auditing
  • Enforcement and discipline
  • Established lines of communication throughout the organization
  • Reporting program

If implemented correctly, the program will assess, identify, own, manage, and mitigate or reduce risk within the organization and protect employees. Compliance needs to be woven into the organization’s basic business foundations. It is a top-down approach in which leadership support is critical. It also needs to be a part of the decision-making process.

Maintaining a culture of compliance in a remote environment

A solid compliance program does not have to suffer in a remote environment. However, it does require organizations to evaluate whether their compliance efforts address the needs of both in-office and at-home workforces so that they can continue to protect the organization, employees, and clients. Consider these tips when determining the ongoing effectiveness of a compliance program.

  • Take time to revisit the organization’s policies and procedures. Organizational standards may not have been built with the remote workforce in mind. They need to be restructured to show compliance is being met while serving the remote environment.
  • Include the right audits and controls. A standard that needs to be included is the process to identify and escalate issues before they become unmanageable. These controls provide the metrics needed to identify leading indicators of what is and what is not working.
  • Be intentional about connection and outreach with employees. Maintaining connectivity virtually can help employees feel a part of the organization. It can be beneficial to encourage video during meetings, which supports interpersonal connections between colleagues.
  • Educate employees on the compliance program. A compliance program is only effective if employees know about it and how it influences their daily activities. Setting clear expectations is a way to ensure employees are knowledgeable about the program and understand what they need to do, including any state or federal regulations that impact their role.
  • Improve communication between supervisors and employees. When employees are not engaged or they’re overworked or feel undervalued, it puts the organization’s ethics and culture of compliance at risk. In a remote environment, creating frequent opportunities to touch base can help organizations gauge employees’ engagement. Surveys and pulse checks with employees give supervisors a way to learn how their employees are thriving in a remote environment.
  • Celebrate good behavior. Because compliance is the role of every employee, reporting issues of noncompliance can be done by employees. It is important to continue to recognize and celebrate employees’ good behavior and employees who identify and report potential compliance issues. Reporting issues of noncompliance should be encouraged in a safe and nonretaliatory manner.

What is on the horizon with compliance regulations

It is difficult to anticipate the changes with compliance regulations. We will continue to see new regulations that will reshape the industry. This requires us to have continued awareness about upcoming regulations and be prepared for the changes. A solid compliance program gives the organization the ability to adapt and adhere to new regulatory changes with little disruption, while maintaining support for current work projects.

Related: How Identifying Your Mission Helps You Stay the Course in an Ever-Changing World


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