Regulatory Compliance Auditor

Brief Description Are you ready to make a real difference in people's lives? Join the Harris Center for Mental Health and IDD as a Regulatory Compliance Auditor. The Regulatory Compliance Auditor provides coordination between the Authority and contracted services programs by technical review of the medical records, billing service codes, contracts and other documents. The Regulatory Compliance Auditor is responsible for carrying out programmatic and departmental goals and objectives as stipulated by Texas Administrative Code (TAC), Medicaid Guidelines, Texas Resiliency and Recovery Guidelines, and Quality Practices of the Agency. This position provides center‑wider oversight to the Intellectual Disability Division (IDD) and Mental Health Division (MH), Forensics and CPEP, related to compliance standards, state and federal guidelines, and contract requirements. This position is responsible for planning and scheduling ongoing audits, collaborating with managers, supervisors and additional staff regarding compliance standards. Travel will be required. Your Role In Action Provides center-wide oversight which includes consultation with all program directors, managers, staff, and unit level program monitors. Conducts inter-rater reviews (review of unit level program monitor’s findings). Provides training/technical assistance and ongoing consultation to Agency divisions and units (inclusive of managers and staff). May participate in the hiring process for program monitor positions as requested. Develops new audit tools and revise/update current audit tools according to Agency P&P and state/federal guidelines. Completes technical reviews of records assuring compliance with all applicable guidelines and reviews of external contractors. Completes audit summary reports, preliminary debriefing reports and final debriefing reports. Reviews all deficiencies as cited and initiates Plans of Improvement (POI) if needed. Participates in state requested, focus, comprehensive and authority reviews. Participates with Agency committees or work groups, if applicable. Contacts sources to validate information received from case reading, sources, and consumers. Provides technical assistance to division programs on compliance issues, identifies trends or problems, and recommends appropriate changes in service delivery. Provides input on the development of quality control policies, procedures, and protocols. Completes operational (site) and State Mystery caller reviews. Participates in assigned Agency investigations and in training and meetings to determine areas for compliance. Coordinates and adheres to State and Insurance requests. Logs and tracks compliant calls and incident reports received in the Department. Facilitates staff in‑services on compliance policies, procedures, and protocols/review tools. Completes assigned reviews and reviews of external contractors. Performs other related duties as assigned. Education Bachelor’s degree (B.A.) or equivalent. Certified in Healthcare Compliance, Certified Compliance and Ethics Professional preferred. Experience One (1) year of experience reviewing or auditing programs that provide behavioral health services or IDD services required OR Two (2) years of experience working in social service with duties to include documentation and record keeping required; Five (5) years of experience preferred. Knowledge, Skills & Abilities Knowledge of federal program policies and laws, of financial and medical eligibility program policies, and of agency quality control procedures. Knowledge of Microsoft Word, Excel, Access, Power Point and Outlook. Knowledge of HIPAA Privacy and Security Rules. Possess strong verbal and written communication skills and interact effectively at all levels within the organization. Ability to interpret policies and procedures, analyze and evaluate quality control case review documentation for accuracy and completeness, to analyze management problems and develop and present alternative solutions. Works with others in a collaborative manner. Actively participates as a member of the team. Demonstrates a commitment to and an integration of The Harris Center values: Integrity, Accountability, Consumer Orientation, Quality, and Efficiency. Must have well-developed interpersonal, organizational, and problem‑solving skills, and be a team player with a desire to provide a high level of customer service. Should have excellent written, verbal and communication. Ability to maintain absolute confidentiality of all work‑related matters and ability to communicate effectively and tactfully with all levels of the agency. What We Have To Offer The Harris Center not only offers a competitive salary but also a suite of excellent benefits designed to enrich your life both professionally and personally. Imagine a future with a robust retirement plan complemented by our generous company matching – a testament to our investment in your long‑term financial well‑being. Experience the unique advantage of our prior service credit, accelerating your journey towards a more substantial Paid Time Off accrual, empowering you to enjoy well-deserved breaks. Enjoy Cell Phone Discounts, exclusive entertainment deals through Tickets at Work, and a free Headspace subscription for mental wellness. Additionally, our Employee Assistance Program supports your overall well‑being. Take advantage of significant financial relief through student loan forgiveness as a valued member of The Harris Center team. As a qualifying entity, our employees are eligible for various student loan forgiveness programs, designed to alleviate the financial burdens associated with higher education. What Else You Should Know This posting is associated with position #1015 This position will be located at 9401 Southwest Fwy. Houston, TX 77074. #J-18808-Ljbffr