COMPLIANCE OFFICER

Overview

Responsible for developing, coordinating, and maintaining systems to ensure compliance and quality assurance with company standards and expectations and State/Federal contractual regulations. Work involves establishing standards and implementing procedures to ensure that the compliance programs throughout the organization are effective and efficient in identifying, preventing, detecting, and correcting noncompliance with applicable laws and regulations.

Essential Duties and Responsibilities

The following duties represent expectations typically associated with this role; other duties may be assigned as the project requirements change.

Compliance / Risk

Support organizational compliance and adherence to all federal, state, and local standards and regulatory requirements.

Support AIHS’s HIPAA Officer while providing ongoing education and monitoring of employees as assigned.

Support development of and provide compliance expectation learning for all levels of AIHS employees.

Enforce adherence to policy and process and take appropriate actions to encourage accountability while fostering a learn and grow culture.

Conduct internal audits and risk analysis as needed.

Oversee grievances and work with department leaders to resolve investigations within the incident reporting system.

Monitor and identify any violation of rules, regulations, or established requirements and report them to BDS through the incident reporting system as outlined in Indiana Administrative Code, Indiana Code and BDS policy.

Design, coordinate and maintain various aspects of the client safety and risk management programs for all AIHS departments.

Review, investigate and analyze incidents for risk and adverse event identification, loss prevention and claims management purposes, including both potential and actual client or staff injury.

Recommend interventions which will enhance the safety and well-being of clients, staff, and the organization at large.

Support VP of Administration in mobilizing departmental employees or administrative support to address unresolved high-risk practices.

Quality / Accreditation

Responsible for supporting VP of Administration in maintaining organization-wide quality program; to include collecting, aggregating, and analyzing data.

Support development, maintaining, and utilization of quality assurance policies and procedures.

Focus on high value and quality, including the improvement of client outcomes and experiences along with safety, costs, revenue, productivity, efficiency, and employee satisfaction, as well as process reliability.

Collect, and knowledgably report on requested key performance indicators (KPI) data for the organization.

Accountable for monitoring of trends in key performance indicators to evaluate effectiveness, reliability, efficiency, etc. using available information systems data.

Use data from appropriate external sources, including comparative databases.

Manage performance improvement project flow and alignment to assure milestones and key performance indicators are met within defined parameters.

Document the results of projects, and submit all documentation as requested.

Evaluate and document the effectiveness of AIHS’s quality management system.

Review incident report and mortality reviews to determine trends with analysis and provide recommendations to management for addressing trends.

Complete assessments of providers as assigned.

Conduct Quality Assurance calls, data collection, and reports as assigned.

Oversee completion of file audits on care management staff to assure compliance with established standards.

As directed by VP of Administration, collect and coordinate internal data to meet requirements for accrediting bodies and contractual and/or Governmental regulations including but not limited to NCQA, Medicare/ Medicaid, and HIPAA.

Other functions/duties:

Update professional knowledge by participating in educational opportunities and reading professional publications.

Communicate with all assigned staff on daily basis and report all areas of concern/issues/incidents to supervisor immediately.

Complete annual performance evaluation for assigned employees and implement plans of correction when needed.

Serve as an example of agency Standard of Excellence by communicating to assigned staff and exemplifying agency vision and goals.

Demonstrate professionalism in relationships with customers/co-workers/assigned staff/etc.; build rapport while refraining from inappropriately familiar personal relationships.

Review and attest to accuracy of payroll records and submit for processing according to agency schedule.

Other Duties and Responsibilities

Other duties as assigned.

Represent agency at community events.

Serve on external and internal agency-wide committees.

Required Education and Experience

Bachelor’s degree from four-year college or university in social work, sociology, counseling, psychology, gerontology, valid IN RN license or a BA degree in any field with a minimum of two years full-time, direct service experience with the elderly or disabled which includes assessment, care plan development and monitoring; or a Master’s degree in a related field may substitute for the required experience.

Preferred Education and Experience

Previous experience as a Compliance Professional with at least 1 year in a full-time compliance position or 1500 hours direct compliance job duties. Previous experience working in a university, hospital, or healthcare/related organization.

Expected Hours of Work

This is a fulltime exempt position. Agency business hours are typically Monday through Friday, 8:00am-4:30pm. Hours may vary depending on the agency’s needs.

Travel

Little to no travel is anticipated with this position, but position may include travel throughout agency’s service area at times.

Physical Demands

The individual must be able to communicate effectively with others and enable understanding by others through communication. The individual is required to sit and/or stand for long periods of time.

Work Environment

This job operates in a professional office environment using standard office equipment such as computers, phones, photocopiers, fax machines, etc.