Compliance Director - Lifeways Inc
Ontario, OR 97914
About the Job
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.
Source : Lifeways Inc
