The Manager of Compliance & Records Retention Department is responsible for oversight of electronic scanning and auditing of client, employer and employee files for compliance. Additional responsibilities include handling complaints, fraud and ANE reports.

Tasks:

• Oversee the performance and quality of client, employer, and employee file audits to ensure they meet State and Federal program rule requirements.

• Recommend updates to policies and procedures to ensure compliance with State and Federal program rules.

• Document areas of non-compliance to suggest necessary education to other departments.

• Develop and/or maintain monthly and quarterly compliance review plan, including a reporting mechanism to be delivered to the Vice President of Operations.

• Provide support for other reporting requirements, including analysis and compilation of data related to programs and services for monthly, quarterly, and annual reports; as directed by the Vice President of Operations.

• Investigate all reported potential fraud complaints or non-compliance complaints and work with the appropriate supervisor and service advisor to create a corrective action plan and/or a report to OIG.

• Review both employer and employee files that have been scanned for completeness and using our audit tools, ensure that the files meet state and federal program rules

• Random checks of A/P, Payroll, and billing to ensure that these amount match and will assist with the program year end reconciliations between billing and payroll.

• Perform company/departmental audits as requested such as ensuring that monthly and annual OIG/NAR checks are done and that all CLASS, DBMD and MDCP employees keep current with their CPR.

• Suggest changes to current protocols and procedures to improve accuracy and retrievability of documents.

• Monitor and report issues of non-compliance to the Vice President of Operations.

• Compile monthly summaries of all reviews for chart audits, complaints, ANE reports, and fraud allegations

• Ensure that annual licensure and evaluation forms are completed

• Supervise employees in the department

• Respond to contract and fiscal monitoring requests from HHSC and/or MCOs.

• Use spreadsheets and other tools to develop concise and dependable tracking mechanisms to identify and report trends.

• Observe confidentiality policies at all times.

• Comply with federal, state, & company policies, procedures, and regulations.

• Perform other related duties as assigned.

Skills/Attributes:

• Able to work independently.

• Able to work with a team to accomplish goals and objectives.

• Excellent time management skills and multi-task in a fast-paced environment.

• Effective organizational skills with strong attention to detail.

• Excellent interpersonal relations skills, including active listening skills such as giving full attention to what other people are saying, taking time to understand the points being made, and asking questions as appropriate.

• Willingness to work with health care professionals, clients, families, and the general public.

• Written and verbal communication skills are required to communicate effectively as appropriate to the needs of the audience.

• Must be able to read, write and comprehend English; must be able to communicate efficiently in English.

Experience and Education:

• High school diploma or GED required.

• Two (2) to Four (4) year of experience in the field of auditing or in a related area.

One (1) year of experience in the healthcare field highly desired.

• Bilingual (Spanish) preferred.

• Must be able to demonstrate competence with computer applications such as MS Word and Excel and have the ability to readily learn agency specific software.

• Must be able to type 35 wpm with 80% accuracy and 80% accuracy in Excel.

Physical Requirements:

• Ability to work up to a minimum of 40 hours per week.

• Sitting in a normal seated position for extended periods of time.

• Able to write up to 3 hours per day.

• Sitting in a normal seated position for extended periods of time.

• Reaching by extending hand(s) or arm(s) in any direction.

• Finger dexterity required to manipulate objects with fingers rather than with words, hand(s)

or arm(s); for example, using the keyboard.

• Communication skills using the spoken word.

• Ability to see within normal parameters.

• Ability to hear within normal range.

• Ability to move about.

Apply online to become a part of our compassionate and dedicated team www.dsswtx.org or submit your resume directly to

https://dsswtx.jotform.com/220836269749065