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Chief Compliance and Quality Assurance Officer
2 months ago
ABOUT NORTHSIDE CENTER
Northside Center is recognized for its exceptional work environment and dedicated teams of professionals in education and clinical services.
Our primary goal is to fulfill our mission of providing essential support to children and families, enabling them to overcome challenges and flourish.
We are committed to delivering high-quality, outcome-oriented behavioral, mental health, and educational services that empower vulnerable children to rise above the detrimental effects of poverty and discrimination, paving the way for a future limited only by their aspirations.
OBJECTIVES:
The primary aim is to lead and enhance the strategic and operational performance of the Compliance and Quality Assurance department.
This encompasses ensuring compliance with industry standards and regulations, spearheading continuous improvement initiatives, and cultivating a culture of excellence and accountability.
This position requires the application of data-driven strategies to evaluate and enhance the effectiveness of compliance measures, promote ongoing improvement initiatives, and achieve the intended outcomes of our programs.
DUTIES AND RESPONSIBILITIES:
Develop, implement, and revise policies and procedures at least annually, or as necessary, to align with changes in Federal and State laws, regulations, and standards.
Annually prepare a compliance work plan that outlines the proposed strategy for meeting compliance requirements for the upcoming year.
Possess the ability to comprehend, interpret, and ensure adherence to local, state, and federal regulations. Stay informed about changes in regulatory standards and communicate these updates to relevant departments.
Identify potential risks that may affect Northside's reputation, safety, security, and financial health. Formulate and implement policies and procedures to mitigate these risks.
Assess the effectiveness of programs and initiatives to ensure they achieve desired outcomes. Utilize data-driven insights to enhance program implementation and success.
Establish and execute quality control systems to guarantee that Northside's services meet established standards. Monitor performance, provide recommendations for improvement, and implement necessary changes.
Regularly report, at least quarterly, to the required governing body, chief executive, and compliance committee regarding the progress of adopting, implementing, and maintaining the compliance program.
Assist Northside in identifying methods to enhance efficiency, service quality, and reduce vulnerability to fraud, waste, and abuse.
Investigate and take independent action on matters related to the compliance program, including designing and coordinating internal investigations and documenting, reporting, coordinating, and pursuing any resulting corrective actions with all internal departments and contractors.
Develop and implement an annual training program covering various topics, including risk areas, policies and procedures, roles of compliance officers and committees, internal reporting for potential compliance issues, and billing requirements.
Coordinate the implementation of the fraud, waste, and abuse prevention program as applicable. Conduct periodic audits and monitoring activities as part of the annual Compliance Work Plan.
Recruit, manage, and develop staff to ensure they effectively perform their responsibilities in the daily operations of the compliance and quality management department, based on Northside's risk areas and organizational experience.
SPECIFIC SKILLS:
Possess extensive knowledge and experience regarding the legal requirements associated with Medicaid, capable of implementing programs designed to detect, prevent, report, and rectify instances of fraud, waste, and abuse within Medicaid programs.
Ability to collaborate with a diverse range of individuals, negotiate effectively, particularly with various departments within the organization.
Strong writing, relationship-building, interpersonal, and presentation skills. Critical thinker, analytical, and detail-oriented.
Creative, strategic, and results-oriented. Team player, adaptable, and capable of thriving in a complex and fast-paced environment while managing multiple relationships and projects under tight deadlines.
CORE COMPETENCIES:
Strong work ethic. Commitment to working in a mission-driven organization. Demonstrated personal ethics and values. Cross-team collaboration and cooperation. Team player who works effectively with a diverse group of individuals.
QUALIFICATIONS:
Bachelor's Degree required (MBA preferred). 6-10 years of experience in the Not-For-Profit sector, with comprehensive knowledge of Office of Inspector General (OMIG) industry standards and regulations.
Proven experience as a compliance manager. Excellent knowledge of reporting and record-keeping procedures.