Compliance Officer

• The Compliance Officer oversees and monitors all aspects of the Corporate Compliance Program within the agency, and functions independently to ensure the agency compliant with all regulatory requirements and industry standards, and that agency policy and procedures are being followed.
• Reports to the Executive Director and Board of Directors no less than quarterly on Compliance activities
• Reviews and evaluates annually as well as monitors, develops, implements, and updates a compliance work plan that outlines the agency’s strategy and effectiveness for meeting the requirements of the Compliance Program
• Monitors regulatory developments, changes in Federal and State laws and regulations, and industry practices that affect the organization's operations, and ensures timely updates to compliance policies and procedures.
• Reviews all Compliance policy and procedures, and the Standards of Conduct no less than annually, and updates them as needed.
• Coordinates the Compliance Committee meetings with its members, reports to the Committee any changes in federal and state law and regulations, and any updates to policy. Retains meeting minutes as required.
• Responds to reports of fraud, waste, and abuse of Medicaid dollars, violations of the agency Standards of Conduct, and other violations of the law. Investigates any reports of fraud, waste, and abusive practices within the agency and develops a plan of corrective action.
• Develops and conducts internal audits of compliance risk areas, performs regular billing audits and QA reviews to identify any issues or gaps, and develops corrective action plans as necessary.
• Monitors and oversees the Compliance violations reporting process, including the compliance hot line.
• Works with external stakeholders as required: (ie:Justice Center, OMIG, OIG, OMH)
• Monthly random audit reviews verifying authorization, progress notes, service plans meet compliance for billing
• Responsible for Incident Management investigations and required reporting.
• Responsible for Incident Review Committee Meetings
• Responsible for Board of Director Compliance Training and Documentation
• Provides support, as needed, for other required staff training.
• Administrator and Security Manager for Foothold, CAIRS, MHPD and all related software

QUALIFICATIONS

Education: A Bachelor’s degree in Law, Healthcare Administration, Business Administration, Social Work or other relevant field is required; Master’s Degree in similar field or a professional license (RN, LCSW, LMHC) and professional certification in compliance or a relevant discipline is preferred (CPCO, CHC, RHIA)

Experience: A minimum of 10 years’ experience in a healthcare organization, to include demonstrated leadership. Familiarity with operational, financial, quality assurance, and human resource procedures and regulations is a must.