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Director of Compliance/Government Regulation

4 months ago

Milwaukee, United States Outreach Community Health Centers Full time
Job DescriptionJob Description

JOB SUMMARY:

The Director of Compliance/Government Regulation provides professional direction, oversight, and advice to the Health Center’s Compliance and Quality Improvement Programs, encompassing all clinical and administrative departments. As the designated Compliance Officer, this role is responsible for implementing the Compliance Program and reports directly to the CEO and Board of Directors.

JOB RESPONSIBILITIES:

  1. Regulatory Oversight: Oversee, monitor, and enhance compliance with federal, state, and county regulations affecting health center operations, billing, and grant-funded programs.

  2. Leadership Role: Serve as a member of the Health Center’s Leadership Team, contributing to strategic decisions and policy development.

  3. Regulatory Knowledge: Stay current with federal and state rules and regulations governing Federally Qualified Health Centers (FQHCs).

  4. Annual Work Plan: Develop an annual work plan to identify and prioritize regulatory compliance items, high-risk areas, and potential vulnerabilities. Create strategies to address and improve weaknesses.

  5. Audits and Best Practices: Conduct periodic audits to ensure regulatory compliance and assist in developing best practice workflows to minimize risk of error or fraud.

  6. Incident Investigation: Assist with investigating incidents related to healthcare coding, billing, reimbursement, allegations of fraud, abuse, conflicts of interest, and breaches of privacy, confidentiality, and security.

  7. Policy Development: Develop policies and procedures related to standards of conduct, compliance with laws and regulations, and the reporting of suspected fraud or misconduct.

  8. HIPAA Compliance: Assist in drafting policies and procedures related to HIPAA and other regulations as needed.

  9. HRSA Site Visit: Lead HRSA Site Visits, including preparation, execution, and post-visit activities.

  10. Audit Analysis: Analyze findings from internal and external audits and site visits to evaluate compliance with laws, regulations, and standards.

  11. Reporting System: Establish and manage a reporting system for employees to report concerns and obtain assistance, ensuring mechanisms for enforcing compliance and addressing violations.

  12. Documentation: Maintain records to document compliance efforts and corrective actions.

  13. Internal Investigations: Conduct or oversee internal investigations of alleged compliance violations to determine if corrective actions are necessary.

  14. Grants Compliance: Collaborate with the Grants Director/Manager and Program Managers to ensure compliance with federal and state grants, including HRSA 330 and Ryan White HIV/AIDS Program grants. Maintain effective communication regarding compliance requirements with project staff.

  15. IT Compliance: Work with the Information Technology Team to ensure compliance with meaningful use regulations and HITECH/HIPAA.

  16. Training: Provide training and technical assistance to relevant staff based on compliance guidelines and standards.

  17. Other Duties: Perform other duties as assigned.

QUALIFICATIONS:

  • Bachelor's degree required, master’s in healthcare administration preferred.
  • Three to five years of experience in compliance or grants management.
  • FQHC experience preferred.
  • Proven understanding of compliance, risk assessment and mitigation.
  • Knowledge of federal and state grant regulations, including Federal Uniform Administrative Requirements for HHS Awards: 45 CFR 75 and accreditation requirements.
  • Ability to plan and organize multiple tasks while working as part of a team.
  • Ability to relate well to people from diverse ethnic and cultural backgrounds.
  • Demonstrate initiative, ability to work with others, and good professional judgment which includes exemplified expertise in engaging the commitment of staff, clinicians, administrators, and board members in a shared “Culture of Compliance” at the Health Center.
  • Ability to work independently and organize time effectively.
  • Excellent written and verbal communication skills.
  • Strong organizational skills and attention to detail.
  • Working proficiency in Microsoft Word, Excel, Outlook, and Power Point.

Outreach Community Health Centers welcomes all
Outreach Community Health Centers, Inc. is an Affirmative Action/Equal Opportunity Employer. We consider qualified applicants for employment without regard to race, religion, color, national origin, ancestry, age, sex, gender, gender identity, gender expression, sexual orientation, genetic information, medical condition, disability, marital status, or protected veteran status.

Company DescriptionOutreach Community Health Centers provides high-quality primary, family and behavioral health services to people throughout the Greater Milwaukee area. Outreach Community Health Centers provides person-driven and evidence-based practices.

Outreach Community Health Centers maintains its founding mission to serve the homeless, those experiencing extreme poverty and the uninsured. Outreach Community Health Centers serves the most disadvantaged people in Milwaukee County.

Our Mission is: To promote health and wellness to all individuals that we serve.Company DescriptionOutreach Community Health Centers provides high-quality primary, family and behavioral health services to people throughout the Greater Milwaukee area. Outreach Community Health Centers provides person-driven and evidence-based practices.\r
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Outreach Community Health Centers maintains its founding mission to serve the homeless, those experiencing extreme poverty and the uninsured. Outreach Community Health Centers serves the most disadvantaged people in Milwaukee County.\r
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Our Mission is: To promote health and wellness to all individuals that we serve.