Compliance Director

2 months ago

Ontario, United States Lifeways Inc Full time $49
ESSENTIAL JOB DUTIES AND RESPONSIBILITIES (This is not an exhaustive list of all duties/responsibilities. Other duties may be assigned)

  • Act as Compliance, Quality Assurance and Mental Health Abuse Investigations Director for the organization.
  • Responsible for development, day-to-day management, and oversight of the compliance, quality assurance and mental health abuse investigation programs.
  • Complete an annual compliance work plan, an annual Quality Assurance (QA) plan, an agency-wide risk assessment, and maintain and submit an annual HHS Breach Report.
  • Revise and oversee agency compliance and privacy policies/procedures, agency records, contracts, Business Associate agreements, and standards of conduct to ensure agency policies are updated regularly, comply with evidence-based practices, and in accordance with statutes and state and federal regulations.
  • Develop and implement a training program that include:
  • Agency-wide training for new employees on compliance, prevention of fraud, waste & abuse, and Lifeways’ Code of Conduct, HIPAA privacy regulations.
  • On-going clinical, compliance, and QA training for employees working in high-risk positions.
  • Regularly report to the CEO and Board of Directors on efforts to develop and implement effective compliance, privacy, and quality assurance programs.
  • Communicate to employees the importance of reporting suspected wrongdoing to Lifeways and manage anonymous and confidential reporting mechanisms including a “hotline” for reporting suspected misconduct, fraud, waste, or abuse.
  • Conduct regular audits of agency compliance records, billing, electronic medical records including service documentation and privacy records, to help reduce agency risk, breaches, destruction & retention, and to comply with regulations.
  • Direct investigations into compliance related activities and potential breaches of Personal Health Information.
  • Direct mental health screening and investigation of potential abuse and ensure 24/7-365 screening of abuse reports as per Oregon Administrative Rules (OAR’s).
  • In conjunction with the CEO, Lifeways Board, and Lifeways legal counsel determine appropriate agency response to detected violations.
  • Organize and participate in QA, Coordinated Care, Compliance, HIPPA Compliance and other job-related committees.
  • Direct response of privacy practice complaints and client and community partner complaints associate agreements for privacy requirements, and daily review of reportable QA incidents.
  • Ensure regular inspections of agency facilities and privacy practice procedures, and ongoing monitoring of business.

Compliance:
  • Implement, manage, and monitor compliance program, in collaboration with Executive Management.
  • Ensure ongoing surveillance of clinical service documentation, billing practices, and OIG FFP exclusion requirements.
  • Monitor and respond to confidential and anonymous reports of fraud, waste, abuse, or other illegal or unethical reported behaviors.

Quality Assurance:
  • Develop, implement, and conduct systematic continuous assessment of clinical documentation, quality of service and client outcomes.
  • Direct interpretation of QA and behavioral healthcare rules and provider regulations.
  • Direct clinical service and billing audits.
  • Direct and report on quality improvement, data analysis, and consumer satisfaction surveys.

Privacy:
  • Coordination of HIPAA privacy compliance activities.
  • Help establish and maintain a mechanism to track access to protected health information as required by law.
  • Oversee the Privacy Rules of clients to inspect, amend, and restrict access to their protected health information (PHI).

MH Abuse Investigations:
  • Monitor abuse screening timelines and report submissions of agency MH abuse investigators.
  • Liaison with the OHA Office of Investigations, Training, and Safety (OTIS) as needed.

Required Qualifications:
  • Master’s degree in human services, social work, counseling, or LMFT.
  • Certified Healthcare Compliance Certification or equivalency within 2 ½ years of hire.
  • Completion of the OTIS MH Abuse Investigator Training within 1 year of hire.
  • Valid driver’s license.
  • Must pass a criminal background check.

Preferred Qualifications:
  • Five years’ experience working in a regulated environment.
  • Two years of direct clinical experience in behavioral health.

Benefits offered:
  • $3,000 new hire bonus (new hired full-time staff).
  • Medical Benefits.
  • Dental Benefits.
  • Vision Benefits.
  • Flexible Spending Account.
  • Health Savings Account.
  • Life Insurance, AD&D - Company Paid.
  • Short Term Disability- Company Paid.
  • Long Term Disability.
  • Supplemental Life Insurance.
  • 401K Retirement Plan (Traditional or ROTH) with Company Funded company match up to 6%
  • Retirement and Financial Planning Services.
  • Shift differential incentives.
  • Loan Forgiveness options through federal programs (National Health Service Corps & Public Service Loan Forgiveness).
  • We provide professional development to enhance various skills, certifications, and continuing education.
  • Opportunities for growth and movement - We encourage our employees to consider new growth opportunities with us and have opportunities.
  • Paid Time Off (amount depends on years of service).
  • Sick Leave for part-time staff.
  • (11) Paid Holidays.
  • Tuition reimbursement program.
  • Commuter Mileage Incentive.
  • Cell phone reimbursement.
  • Clinical Supervision.
  • Wellness Program reimbursement.
  • Employee Assistance Program - assists employees with personal problems and/or work-related problems that may impact their job performance, health, mental and emotional well-being.

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