Description

We are seeking a full time Compliance Specialist to join our PACE team! 

Apply today with PACE of Southwest Michigan!

We offer a competitive salary and benefit package, that includes medical, dental, 403B, PTO, holidays off (w/pay) and a M-F work schedule. 

P.A.C.E, which stands for "Program for All-Inclusive Care for the Elderly", is a unique option for older adults who wish to remain in their home as they age. Our goal is to provide senior community members with the care, medical treatment and support they need to achieve the highest quality of life.

We are actively recruiting for a Compliance Specialist. This position requires a dynamic individual, who enjoys working in an environment that encourages developing relationships with our PACE team, participants and their caregivers, where a team focused approach to care is the cornerstone of our organization.

The Compliance Specialist will assist in developing, promoting, and maintaining an effective Compliance Program for PACE of SWMI. This position will help ensure operations comply with relevant laws, regulations and internal policies through proactive monitoring, internal auditing, and employee education. Work includes but is not limited to FWA (Fraud, Waste, and Abuse), HIPAA, policy development, and other special projects as directed.

Key Responsibilities

· Assist in the development, implementation, education, and maintenance of the Compliance Improvement Plan (CIP)

· Perform various internal audits to ensure compliance with CMS and State regulations

· Monitor and track exclusion and preclusion screening for employees and external providers

· Assist in compliance education and training of PACE employees

· Monitor and track critical organizational submissions

· Create, send, and track proactive compliance emails and notices 

· Provide guidance with HIPAA questions, privacy complaints and investigations

· Research laws and statutes as applicable to compliance issues

· Coordinate and compile responses for submission to regulatory agencies

· Track and compile multiple documents for audits, investigations, training, etc. 

· Prepare finalized documents for external submissions

· Implement and monitor Corrective Action Plans

· Review and modify internal policies and procedures as necessary 

· Collaborate with all departments to revise policies and procedures to ensure they satisfy regulatory requirements

· Monitor adherence with PACE policies and procedures

· Respond to day-to-day compliance inquiries from staff

· Inform Compliance Officer regarding situations of non-compliance

· Serve as back-up to Compliance Officer

· Abides by all established PACE of Southwest Michigan policies, rules, and regulations

· All other duties as assigned

Requirements

Specifications
Education: High School diploma or GED required. Associate degree in related field preferred or equivalent with a minimum of two (2) years previous compliance-related experience.
Experience: Relevant compliance, legal, or privacy experience or coursework in healthcare setting; Auditing, monitoring, investigations, and/or training experience preferred. 

Licensure, Registry, or Certification Required: If licensed or certified, must possess an active, unencumbered license/certificate to practice in the State of Michigan; Valid MI Driver’s License Preferred

Special Training: Only acts within scope of practice. Meet a standardized set of orientation and/or individual competencies for the specific position description established by PACE of Southwest Michigan and approved by CMS before working independently. 

Immunizations: Be medically cleared for communicable diseases and have all immunizations up to date before engaging in direct participant contact.

Specific Requirements and Considerations: May be subject to exposure and handling of infectious waste, diseases, conditions, or hazardous chemicals, etc., including potential exposure to TB, AIDS, and/or Hepatitis B. 

Ages of Patients Rendered Care: Adult, Geriatric

Skills and Knowledge

· Excellent attention to detail

· Willingness to learn and ask questions

· Proficient in Microsoft Outlook, Excel, and Word

· Strong critical thinking and analytical skills

· Effective organizational and documentation skills

· Ability to prioritize duties and manage multiple projects simultaneously

· Excellent interpersonal and communication skills, both verbal and written

· Able to effectively build professional relationships and collaborate with all team members

· Ability to read, understand, and follow laws, regulations, and policies 

· Working knowledge of clinical terminology, healthcare operations, and HIPPA/Privacy rights – preferred

· Ability to work a flexible schedule

Physical Demands 

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is regularly required to talk and hear. The employee frequently is required to sit and use hands and fingers, handle or feel objects, tools or controls. The employee is occasionally required to stand and walk. The employee must be able to travel in all kinds of weather.

While performing the duties of this job, the employee is required to frequently move up to 50 pounds and perform physical demands expected while providing medical care for an elderly population. Specific vision abilities required by this job include close vision, distance vision and the ability to focus.

Every effort has been made to identify the essential functions of this position. However, this in no way states or implies that these are the only duties you will be required to perform. The omission of specific statements of duties does not exclude them from the position if the work is similar, related, or is an essential function of the position.