Clinical Compliance Auditor

Clinical Compliance Auditor

HarmonyCares is one of the nations largest home-based primary care practices. HarmonyCares is a family of companies all dedicated to providing high-quality, coordinated health care in the home. This includes HarmonyCares, HarmonyCares Medical Group, HarmonyCares Home Health, HarmonyCares Hospice and The Home DME.

Our Mission Through Compassionate Patient-Centered Care in the Home; We will Provide Exceptional Outcomes across our Continuum of Services

Our Values Respect, Integrity, Teamwork and Excellence - are leading us to a better tomorrow for patient care. 

Why You Should Want to Work with Us

• Health, Dental, Vision, Disability & Life Insurance, and much more
• 401K Retirement Plan (with company match)
• Tuition, Professional License and Certification Reimbursement
• Paid Time Off, Holidays and Volunteer Time
• Paid Orientation and Training
• Day Time Hours (no holidays/weekends) Great Place to Work Certified
• Established in 11 states
• Largest home-based primary care practice in the US for over 28 years, making a huge impact in healthcare today!

Position Description

The Clinical Compliance Auditor is a compliance professional that designs and conducts medical record audits and reviews, guides compliance cases and associated corrective actions, and assists with the development and implementation of the HarmonyCares Compliance and Ethics Program. 

Essential Duties and Responsibilities

• Designs audit protocols and performs audits and reviews to evaluate compliance with Medicare, Medicaid, or other applicable payor standards and internal expectations
• Assists management with the design of specific monitoring protocols
• Tests monitoring protocols for effectiveness
• Supports the Confidential Disclosures Program and performs or assists with internal investigations and design of associated corrective actions.  Prepares and reviews investigation reports
• Works collaboratively with stakeholders with design of internal controls and corrective and preventive actions; monitors corrective actions to completion

• Provides guidance and assistance in creating and updating workflows, policies and procedures.
• Assists with creation and revision of educational materials based on audit and investigation findings and associated potential risks.  When necessary, delivers direct education
• Drafts responses to external audits or inquiries from regulatory agencies (e.g., ZPIC, OIG, MAC, etc.), as assigned
• Collects, organizes, and analyzes monitoring and auditing information, identifies potential risks, and provide feedback to management
• Periodically evaluates, revises and refines audit plans and methodologies based on regulatory and internal standards
• Maintains tracking mechanisms and electronic systems (e.g., databases) as assigned
• Raises awareness of the Compliance and Ethics Program and fosters accountability for ethics and integrity throughout the organization
• Stays informed about regulatory standards and changes; provides education and advice on operational changes to company stakeholders
• Champions a proactive approach to compliance that is focused on partnership, collaboration, prevention and reduction of risk
• Other duties as assigned

REQUIRED Knowledge, Skills and Experience

• Bachelors degree
• Current, unencumbered licensed Nurse Practitioner/Physicians Assistant, or Registered Nurse
• 5+ years of compliance, clinical internal audit, and/or healthcare management experience
• Excellent organization and follow-up skills including the ability to handle competing and changing priorities and to meet deadlines and commitments
• Excellent analytical and problem-solving skills
• Excellent communication and people skills, both verbal and written

Wont you join us? We are seeking candidates who desire the opportunity and experience of delivering quality and compassionate healthcare - within proven care models to elderly individuals and those with complex medical issues, who are the forefront of everything we do.