Behavioral Health Compliance Manager

6 days ago


Scottsdale, United States SPECTRAFORCE Full time

Job Title: Behavioral Health Compliance Manager I

Location: Scottsdale, AZ

Full-time

The Compliance Manager ensures that the client continually develops and executes all aspects of its Compliance Program, primarily related to behavioral health best practices and Federal/State Medicaid, HIPAA, MCO/Payer Compliance, and Joint Commission requirements.

The Compliance Manager’s Primary Duties are to work in conjunction with the client's Leadership and Management to

  • Identify and assess areas of compliance risk primarily through ongoing internal audit.
  • Update client’s Compliance Program accordingly.
  • Ensure that policies and procedures are updated accordingly.
  • Monitor ongoing changes and updates to external quality standards and expectations identified by AHCCCS and implemented by managed care organizations.
  • Prepare, execute and communicate around the audit processes of our outside stakeholders (Federal/State Medicaid, HIPAA, MCO/Payer Compliance and Joint Commission etc.).
  • Coordinate Quality Management Performance Improvement monitoring, including but not limited to identification of internal quality metrics within various departments in the organization, collection of data, implementation of corrective action as needed, and monitoring of outcomes and effectiveness.
  • Ongoing communication with client's senior leadership around compliance effectiveness.

Requirements:

  • Medicaid compliance management or Medicaid service delivery experience.
  • (Behavioral health?) Compliance management experience.
  • Behavioral Health licensure


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