Director of Compliance/Government Regulation
, ID, United States
JOB SUMMARY: The Director of Compliance/Government Regulation provides professional direction, oversight and advice to the Health Center’s Compliance and Quality Improvement Programs, which incorporate all clinical and administrative departments. Serves as the designated Compliance Officer for the Health Center and is responsible for implementation of the Compliance Program. (For this responsibility reports to the CEO and Board of Directors).
JOB RESPONSIBILITIES:
Oversee, monitor, and improve SSCHC compliance with federal, state and county governmental regulations for overall health center operations, billing, and grant-funded programs;
Serves as a member of the Health Center’s Leadership Team;
Maintain an up-to-date knowledge of federal and state rules and regulations that govern Federally Qualified Health Centers (also known as Community Health Centers)
Create an annual work plan that identifies and prioritizes regulatory compliance items, high risk areas, potential vulnerabilities, and develops plans to improve identified weaknesses;
Conduct periodic audits to identify compliance with regulations and to assist in development of best standard workflows that create checks and balances reducing the risk of error or fraud;
Assist with investigating potential incidents pertaining to healthcare coding, billing and reimbursement, any allegations of fraud, abuse or conflict of Interest, suspected or actual breaches of privacy, confidentiality, and security;
Develops policies and procedures related to standards of conduct, compliance with applicable laws and regulations, and the reporting of suspected fraud or impropriety without fear of retaliation;
Assist with writing policy and procedure in areas of regulation as requested.
Lead HRSA Site Visit including ongoing preparation as well as pre-visit, visit, and post-visit activities and tasks;
Analyzes the findings from any internal or external audits and programmatic site visits to assess compliance with applicable laws, regulations, and standards;
Establishes and manages a reporting system for employees to report concerns and obtain assistance; ensures adequate mechanisms exist for enforcement of compliance requirements and violation discipline;
Ensures adequate records are maintained to document compliance efforts and corrective actions;
Conducts, supervises, or coordinates internal investigations of alleged compliance violations, to specifically identify whether any corrective actions are needed;
Collaborate with the Grants Director/Manager, Program Managers and Leadership Team to ensure compliance with regulations of all federal and state governmental grants, including HRSA 330 and Ryan White HIV/AIDS Program grants; Maintain effective communication regarding compliance requirements with staff responsible for project implementation;
Work with Information Technology Team to ensure compliance with meaningful use regulations and HITECH/HIPAA;
Provide training and technical assistance, when required, to relevant staff based on compliance guidelines, requirements, and standards;
Other duties as assigned.
QUALIFICATIONS:
Bachelor degree required, Master’s in healthcare administration preferred;
Three to five years of experience in compliance or grants management;
FQHC experience preferred;
Proven understanding of compliance, risk assessment and mitigation;
Knowledge of federal and state grant regulations, including Federal Uniform Administrative Requirements for HHS Awards: 45 CFR 75 and accreditation requirements;
Ability to plan and organize multiple tasks while working as part of a team;
Ability to relate well to people from diverse ethnic and cultural backgrounds;
Demonstrate initiative, ability to work with others, and good professional judgment which includes exemplified expertise in engaging the commitment of staff, clinicians, administrators, and board members in a shared “Culture of Compliance” at the Health Center;
Ability to work independently and organize time effectively;
Excellent written and verbal communication skills;
Strong organizational skills and attention to detail;
Working proficiency in Microsoft Word, Excel, Outlook, and Power Point.
Considerations & Statement
Outreach Community Health Centers requires employees in certain departments to be fully vaccinated against COVID-19, MMR, Varicella and Influenza .
Outreach Community Health Centers welcomes all
Outreach Community Health Centers, Inc. is an Affirmative Action/Equal Opportunity Employer. We consider qualified applicants for employment without regard to race, religion, color, national origin, ancestry, age, sex, gender, gender identity, gender expression, sexual orientation, genetic information, medical condition, disability, marital status, or protected veteran status.
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