Compliance Specialist (6400 Regulations)

Description

POSITION OVERVIEW

Conducts regular monitoring and auditing to ensure the ICS program's compliance with federal, state and local regulations for areas including but not limited to physical site, health and safety, financial, staff qualifications, provider monitoring and training. Reviews all documentation to assess the quality of care, adherence to company's mission and philosophy, and utilization of best practices. Acts as point person within the statewide Incident Management system for incident management for identified caseload and ensures all investigations are completed per the standards established by internal and external guidelines. Acts as a certified investigator and completes investigations within regulatory guidelines and timeframes.

ESSENTIAL FUNCTIONS:

• Models and promotes both internally and externally the mission, philosophy, and values of InVision Customized Services.
• Integrates departmental operating plans with the overall organizational objectives and goals, policies and procedures, values, and commitments.
• Demonstrates commitment to service excellence and quality improvement.
• Manages incidents within the statewide incident management system from the initial report through the closure of the incident; to include conducting investigations when assigned, external reporting as needed, documentation of the completion of necessary follow up and coordinate corrective actions with the program specialist.
• Reviews and analyzes program documentation to assess the quality of care, adherence to company's mission and philosophy, and utilization of best practices. Outcomes and trends will be reviewed with the compliance managers.
• Completes peer reviews per incident management guidelines; thereby ensuring the quality, integrity, and adherence to best practices throughout the investigatory process is upheld.
• Ensures investigations conducted by the organization are completed utilizing methods outlined in the certified investigators manual written by Labor Relations Alternatives and sanctioned by the state of Pennsylvania by reviewing and providing feedback on investigation reports and acting as a member of the investigatory team.
• Implements systems of audits and/or site inspections to ensure compliance with all applicable regulations, monitoring standards, and relevant statutes.
• Completes necessary additional investigations, audits, and tasks for and in response to licensure surveys/inspections as well as internal identification; prepares related reports and if necessary, plans of correction in consultation with compliance manager.
• During the course of investigations, reviews medical documentation to ensure the medical needs of those supported is managed in a manner consistent with internal policy as well as county, state, and federal regulations and promotes the highest quality of care possible in addition to inspecting residential sites to ensure the health and safety of the persons supported and staff also are in compliance with all regulations and monitoring standards.
• Perform other duties as assigned.

EDUCATION and/or EXPERIENCE:


Bachelor's Degree and two years' experience working in residential programs governed by regulations within the Department of Human Services; Associate's Degree and four years' experience working in residential programs governed by regulations within the Department of Human Services; High School diploma and 6 years' experience working in residential programs governed by regulations within the Department of Human Services. Working knowledge of the Chapter 6400 regulations preferred.

Other Requirements:

• Regional travel.
• Staff hired will be at least twenty-one years of age and will have received Acts 33 and Criminal clearances.
• All staff will be routinely screened for exclusion from participation in Federal Health Care Programs.
• Valid driver's license and current vehicle insurance and access to a vehicle.
• Maintain training compliance as defined in all pertinent regulations.
• Obtain and maintain Certified Investigator credentials.
• Ability to comprehend access and utilize electronic medium and various computer programs.
• Ability to effectively present information, write reports and respond to questions from clients, families and staff
• Ability to comprehend and apply basic mathematical concepts.
• Successful completion of motor vehicle records and background check

PHYSICAL DEMANDS:

While performing the duties of this job, the employee is frequently required to stand, walk, sit and talk or hear, use hands to finger, handle, or feel; reach with hands and arms; climb or balance; and taste or smell. The employee must occasionally lift and/or move up to 20 pounds. Primary environment: ambient room temperatures, lighting and traditional office equipment as found in a typical office environment.


All job requirements listed indicate the minimum level of knowledge, skills, and/or ability deemed necessary to perform the job proficiently. This job description is not to be construed as an exhaustive statement of duties, responsibilities, or requirements. Employees may be required to perform any job-related function as directed by their supervisor.