Compliance Administrator

2 weeks ago

Detroit, United States Detroit Wayne Mental Health Authority Full time
Job DescriptionJob Description

Under the general supervision of the Vice President of Compliance, the Compliance Administrator assists the Vice President of Compliance in ensuring that the Board, management, and employees of DWIHN are following the rules and regulations of regulatory agencies, that DWIHN policies and procedures are being followed, and that behavior in the organization meets the Network’s Standards of Conduct.

PRINCIPAL DUTIES AND RESPONSIBILITIES:

  • Serves as the primary assistant to the Vice President of Compliance for the administration of the DWIHN Compliance Office.
  • Supervises various aspects of the compliance program.
  • Serves as a leader and manages a team of professional investigators and maintains a team-oriented management style.
  • Ensures proper adherence to policies and procedures.
  • Responds to and manages individual compliance cases ensuring departmental compliance with all applicable laws and regulations during departmental actions.
  • Manages and coordinates Compliance Investigations.
  • Trains employees in proper case documentation.
  • Tracks the caseload of the department, including reviewing new cases, tracking case progressions, and ensuring proper case resolution.
  • Partners with colleagues to assist in the development and maintenance of new procedures and operational changes that minimize risk, add value, and anticipate trends in areas of responsibility.
  • Develops and maintains procedures and operational changes that increase productivity, add value, and anticipate trends in areas of responsibility.
  • Maintains meticulous records, including policies, procedures, and compliance documentation, to satisfy client and regulatory agency requirements.
  • Provides oversight of the Certified Community Behavioral Health Clinics (CCBHC) for compliance with SAMSA regulations.
  • Provides indirect oversight of the Community Mental Health Service Providers (CMHSPs).
  • Completes Office of Inspector General (OIG) Reports.
  • Conducts Compliance Staff Training for DWIHN employees.
  • Reviews the DWIHN employee and provider credentialing process for compliance with regulatory standards.
  • Consults with legal counsel as needed to resolve difficult legal compliance issues.
  • Identifies potential areas of compliance vulnerability and risk.
  • Develops and implements corrective action plans for resolution of problematic issues and provides general guidance on how to avoid or deal with similar situations in the future.
  • Provides compliance and other related reports.
  • Researches and analyzes available sources of regulatory guidance in response to specific questions.
  • Monitors available sources of regulatory guidance to proactively address the necessary changes to the HIPAA compliance implementation plan based on documentation and feedback.
  • Maintains a strong working knowledge of applicable regulatory guidelines.
  • Coordinates with the appropriate administrative and support departments to adequately design implementation plans, policies and analyzes the effects of any proposed process changes required by HIPAA.
  • Coordinates the systematic reviews of the various departments' HIPAA compliance status.
  • Performs related duties as assigned.


KNOWLEDGE, SKILLS AND ABILITIES (KSA’S)

  • Knowledge of requirements under Corporate Integrity Agreements (CIAs) and Certificate of Compliance Agreements (CCAs), HIPAA, and the Emergency Medical Treatment and Labor Act (EMTALA).
  • Knowledge of health care fraud and abuse laws, including the False Claims Act, Stark Laws, Sarbanes-Oxley internal controls testing, and the Anti-Kickback Statute, including the associated penalties.
  • Knowledge of health care law, regulations and standards.
  • Knowledge of coding and reimbursement systems, risk management and performance improvement.
  • Knowledge of governmental compliance regulations.
  • Knowledge of DWIHN policies, procedures and practices.
  • Knowledge of the DWIHN provider network and community resources.
  • Knowledge of the Michigan Mental Health Code.
  • Knowledge of MDHHS policies, rules, regulations and procedures.
  • Knowledge of Federal policies, rules, regulations and procedures as it relates to DWIHN.
  • Knowledge of NCQA requirements and the accreditation process.
  • Knowledge of the principles and methodology of total quality management (TQM)/ continuous quality improvement (CQI), specifically the PDSA/PDCA Cycle, quality tools and techniques, and models for improvement.
  • Knowledge of contracting policies and procedures.
  • Knowledge of HIPPA Compliance.
  • Knowledge of Certified Community Behavioral Health Clinics (CCBHC) rules and regulations.
  • Knowledge of SAMSA regulations.
  • Knowledge of Community Mental Health Service Providers (CMHSPs) rules and regulations.
  • Knowledge of Office of Inspector General (OIG) rules and regulations.
  • Supervisory skills.
  • Management skills.
  • Project management skills.
  • Strategic thinking skills.
  • Critical thinking skills.
  • Emotional intelligence skills.
  • Mediation skills.
  • Ethical decision-making skills
  • Rational decision-making skills.
  • Corrective Action skills.
  • Assessment skills.
  • Organizational skills.
  • Planning skills.
  • Accuracy skills.
  • Analytical skills.
  • Time Management skills.
  • Report writing skills.
  • Logical skills.
  • Reasoning skills.
  • Problem Solving skills
  • Decision Making skills.
  • Presentation skills.
  • Interpersonal skills.
  • Public Speaking skills.
  • Multitasking skills.
  • Prioritizing skills.
  • Computer skills
  • Teamwork Skills
  • Ability to communicate orally.
  • Ability to communicate in writing.
  • Ability to work effectively with others.
  • Ability to act ethically and with confidentiality.
  • Ability to work with an ethnically, linguistically, culturally, economically and socially diverse population.
  • Judgement/Reasoning ability.

REQUIRED EDUCATION:

A Bachelor’s degree in Business Administration, Healthcare Administration, Public Administration or related field or a Juris Doctorate.

REQUIRED EXPERIENCE:

Eight (8) years of professional experience working in compliance, healthcare, or law with a proven track record in healthcare regulatory matters.

REQUIRED LICENSE(S).

A valid State of Michigan Driver’s License with a safe and acceptable driving record.

Certification in one of the following, preferred: CHC, CHPC, CHRC, CHC-F.

WORKING CONDITIONS:

Work is usually performed in an office setting but requires the employee to drive to different sites throughout Wayne County and the State of Michigan. This position can work remotely with supervisory approval. Currently this position is a hybrid position.

This description is not intended to be a complete statement of job content, rather to act as a general description of the essential functions performed. Management retains the discretion to add or change the position at any time.

Please Note: DWIHN requires proof of being fully vaccinated for COVID-19 as a condition of employment. Medical or religious accommodations or other exemptions that may be required by law, will be approved when properly supported. Further information will be provided during the recruitment process.

The Detroit Wayne Integrated Health Network is an Equal Opportunity Employer

  • Compliance Administrator

    2 weeks ago

    Detroit, United States Detroit Wayne Integrated Health Network Full time

    Under the general supervision of the Vice President of Compliance, the Compliance Administrator assists the Vice President of Compliance in ensuring that the Board, management, and employees of DWIHN are following the rules and regulations of regulatory agencies, that DWIHN policies and procedures are being followed, and that behavior in the organization...

  • Grants & Compliance Officer

    4 weeks ago

    Detroit, United States Stafford Gray Full time

    Job DescriptionJob DescriptionWill be fully remote while building is constructed, then will become hybridThe Grants & Compliance Officer in the Grants and Contracts Division of Management and Budget will monitor Wayne County’s compliance with general and specific grant requirements contained in the various Federal, State and local grants awarded to the...

  • Senior Compliance Specialist

    6 days ago

    Detroit, United States Soft-World Full time

    Senior Compliance Specialist (Pipeline/Oil &Gas) Location- Washington, MI 48095 (relocation assistance available for non-local talent) Duration - Full Time/Direct Hire Softworld is currently recruiting a Sr. Compliance Specialist to work in hybrid model in Washington, MI. The ideal candidate should possess a minimum of 5 years of natural gas operations,...

  • Administrative Assistant

    1 day ago

    Detroit, United States Entech Medical Staffing Full time

    *JOB OVERVIEW:*We are seeking a skilled and organized Medical Secretary to join our team. As a Administrative Assistant/Medical Secretary, you will play a crucial role in providing administrative support to our medical office. Your attention to detail and ability to handle sensitive information will contribute to the smooth operation of our...

  • Executive Administrator

    2 weeks ago

    Detroit, United States Optimal Inc. Full time

    Job DescriptionJob DescriptionPosition Description:Customer & Dealer Advisory Board Meetings/Event Planning & CoordinationBoard Coordinator of the Fleet Advisory Board (FAB)Leadership & completion of the monthly performance metric reporting cycle.Management of operation's internal control/ corporate compliance to Company's GIM program with annual...

  • Construction Administrator, SFP

    3 days ago

    Detroit, Michigan, United States CHN Housing Partners Full time

    ::: {align="center"}CHN HOUSING PARTNERS:::::: {align="center"}Construction Administrator -- Single Family Preservation:::::: {align="center"} :::We are a growing non-profit organization based in Cleveland, Ohio that offers its employees a comprehensive benefits package, opportunities to grow within the organization, and the ability to improve the...

  • Grants & Compliance Officer

    1 month ago

    Detroit, Michigan, United States Stafford Gray Full time

    Will be fully remote while building is constructed, then will become hybrid The Grants & Compliance Officer in the Grants and Contracts Division of Management and Budget will monitor Wayne County’s compliance with general and specific grant requirements contained in the various Federal, State and local grants awarded to the organization which may include...

  • Home Healthcare Administrative Assistant

    4 weeks ago

    Detroit, United States Crystal Home HealthCare Full time

    Job DescriptionJob DescriptionSalary: Will Be DiscussedAbout Crystal Home Healthcare: With a rich history spanning over 35 years, Crystal Home Healthcare is a Medicare and Medicaid certified home health agency dedicated to providing exceptional healthcare services to homebound patients in the Michigan Tri-County area. Join our seasoned and compassionate team...

  • Compliance Officers

    3 weeks ago

    Detroit Lakes, MN, United States Shearers Full time

    Shearer's is a leading contract manufacturer and private label supplier in the snack industry in North America. Headquartered in Massillon, Ohio, Shearer's has 17 state-of-the-art, geographically diverse manufacturing facilities in Ohio, Texas, Arkansas, Arizona, Minnesota, Pennsylvania, Virginia, Iowa, Ontario and Alberta, Canada, including one of the...

  • Housing Administrator

    5 days ago

    Detroit, United States Presbyterian Villages of Michigan Full time

    Overview: Supervises, directs, coordinates and oversees the operations of the Village. Responsible for guiding the Village in developing strategic initiatives. Responsibilities: 1. Manage and oversee operations, maintenance, administration, and improvement of the Village 2. Conduct supervisory activities such as hiring and firing staff, providing employee...

  • Administrative Assistant

    4 weeks ago

    Detroit, United States Pensole Lewis College Full time

    Job DescriptionJob DescriptionPosition: Administrative Assistant (Full-Time)Company: Pensole Lewis College of Business and DesignDepartment: Education Location: 200 Walker St, Detroit, Michigan, United States (On-site) WHO WE AREPensole Lewis College of Business & Design (PLC) is the Creative Northstar and premier HBCU that is Rebranding Education and...

  • Housing Administrator

    2 weeks ago

    Detroit, Michigan, United States Presbyterian Villages of Michigan Full time

    OverviewSupervises, directs, coordinates and oversees all operations of the Village, including but not limited to management of staff, building operations related to maintenance, vendor relationships, managing within budget, budget development, monitoring and submitting budget and expense requests timely, completing payroll, resident relations, community...

  • Payroll Manager

    4 weeks ago

    Detroit, United States Columbia University Full time

    Position Summary The Payroll Manager plays a pivotal role in overseeing and managing all aspects of payroll processing within the Department of Medicine. This position involves handling salaried transactions, coordinating with various departments, and ensuring compliance with university payroll policies and procedures. The Payroll Manager works closely...

  • Letters of Credit and Trade Services Operations Compliance M

    3 weeks ago

    Detroit, Michigan, United States COMERICA MANAGEMENT CO INC Full time

    Commercial Trade and Letters of Credit - Operations Compliance and Risk ManagerThe Commercial Trade and Letters of Credit - Operations Compliance and Risk Manager is responsible for managing and coordinating all operations risk and compliance activities servicing the Letters of Credit and Trade Services operations in association with the commercial product...

  • Housing Administrator

    3 weeks ago

    Detroit, Michigan, United States Presbyterian Villages of Michigan Full time

    Overview: Supervises, directs, coordinates and oversees all operations of the Village, including but not limited to management of staff, building operations related to maintenance, vendor relationships, managing within budget, budget development, monitoring and submitting budget and expense requests timely, completing payroll, resident relations, community...

  • Legal Administrator

    2 weeks ago

    Detroit, Michigan, United States Geosyntec Consultants, Inc. Full time

    Overview: Do you want to build an impactful career to change the world for the better?  Geosyntec has an exciting opportunity for a Legal Administrator  to provide administrative support to our Legal Department in our Detroit, MI office, remotely from your home-office or any of our U.S. based offices such as: Kennesaw, GA, Boca Raton, FL, Chicago, IL,...

  • Director Ambulatory Services CHM FT Days

    2 weeks ago

    Detroit, United States Tenet Healthcare Corporation Full time

    Children's Hospital of Michigan is an international leader in pediatric and adolescent medicine. Surgical services include general, thoracic, reconstructive and cardiovascular. Imaging technology designed specifically for children provides advanced diagnostic services including Positron Emission Tomography (PET) and MRI. The Children's Hospital of Michigan...

  • Licensing and Permits Manager

    3 days ago

    Detroit, United States Metropolis Full time

    Job DescriptionJob DescriptionPosition: Manager, Licensing and PermitsLocation: Detroit, MI (On Site)Type: Exempt. The Role: A Licensing and Permits Manager assumes responsibility for acquiring essential licenses and permits, ensuring alignment with pertinent regulations, and meticulously documenting all acquired licenses and permits. Reporting directly to...

  • Pharmacy Specialist

    1 week ago

    Detroit, United States Henry Ford Hospital Full time

    GENERAL SUMMARY: The Clinical Pharmacy Specialist-Medication Management, commonly referred to as Drug Information, is a part of the Pharmacy Shared Services team. They are responsible for ensuring the safe use of medications in the health system; managing the health system drug formulary; overseeing medication-related clinical policies and procedures, as...

  • Director - Preoperative Services

    1 month ago

    Detroit, United States Hydro Recruiting Full time

    Job DescriptionJob DescriptionPosition: Director of Perioperative ServicesIndustry: Healthcare / Health Services - Nursing / LPNs / LVNsJob Category: Medical / Health - Nurse LeadershipCompany Overview:Our client offers an array of specialized services including heart care, cancer treatment, gerontology, emergency medicine, obstetrics/gynecology, and...