What are the responsibilities and job description for the Compliance Officer position at Recovery Center of Maryland, LLC?
MISSION
The Recovery Center of Maryland’s mission is to help men and women reclaim their lives from the disease of addiction to alcohol and other drugs and to reduce the incidence of addiction in future generations. We are an agency committed to quality gender-responsive, trauma-informed care for clients with substance use and co-occurring disorders.
JOB DESCRIPTION
Under general direction, an employee in this role has two primary responsibilities: 1) acting as the agency's health care compliance officer and 2) directly managing and supervising the Quality Improvement Department, including responsibility for the coordination and operations of projects related to service program and infrastructure department accountability, quality improvement, and the maintenance and utilization of clinical health records to ensure the highest quality of clinical health records and to ensure that all documentation and billing is compliant in order to avoid reduction in revenue due to deficiencies in either documentation or other non-compliant practices.
RESPONSIBILITIES:
As a Compliance Officer
- Hold primary responsibility for implementing and maintaining an effective healthcare compliance plan that complies with all federal and state regulations.
- Educate the management team and staff about compliance, operational compliance issues, risk issues related to the agency's lines of business, and appropriate details of the compliance program.
- Serve as the agency's HIPAA Privacy and Security officer.
- Create and maintain documentation systems and processes as needed to track, trend, and manage compliance notifications, issues, corrective action plans, audit results, etc.
- Convene to the agency's Critical Incident Review Committee when needed and take primary responsibility for any needed investigation and reporting.
- Ensure corrective actions are adequate and have been implemented for all identified compliance deficiencies.
- Maintain detailed knowledge of contractual requirements and state and county contracts.
- Ensure that our billing programs follow federal and state law and that they are designed to prevent, detect, and correct any associated fraud, waste, and abuse.
- Ensure that all systems are up to date in diagnostic and service code billing practice.
- Please ensure records of compliance and maintain a thorough understanding of state and federal regulations regarding health and school records.
- Ensure that the Board of Directors, management, and employees are in compliance with the rules and regulations of regulatory agencies.
- Promote compliance through effective policies designed to maintain an ethical culture at CHC.
- Coordinate responses to regulatory inquiries.
- Implement and conduct specifically tailored compliance education sessions to address key issues, train new staff, and keep senior management and all other relevant employees apprised of changes to the regulatory environment.
- Participate in other project management and compliance activities as assigned to meet agency objectives and requirements.
- I will take responsibility for implementing policies and procedures, developing training programs, conducting audits, and monitoring compliance-related matters.
- Promote awareness related to information privacy and security and enforce compliance with applicable state and federal laws.
As Quality Improvement Manager
- Support quality improvement by analyzing, developing, implementing, and coordinating the agency's quality improvement program, which is designed to deliver high-quality mental health programs and educational services that align with the agency's clinical and educational frameworks, established practices and systems, contract requirements, and financial goals.
- Support best practice consultation and supervision for direct service staff.
- Provide expertise concerning evidence-based clinical and educational practices and contribute to the continuous development and implementation of improvement activities for clinical and school operations, including education and training. Internal audit/chart review and other internal monitoring processes Measuring client outcomes, satisfaction surveys, program evaluation and other quality indicators
- Manage agency-wide policies and procedures (except for HR policies and procedures).
- Manage agency-wide training and retraining related to the use of EHR, which stands for Electronic Health Record, a digital version of a patient's paper chart.
- Provide expertise concerning the application of EHR-held data to agency business and service practices.
- Perform other related duties as required and assigned.
ACCOUNTABILITY:
Success in this position will be measured by ensuring compliance with federal, state, and county healthcare regulations and that the agency is able to recognize the maximum revenue possible through compliant documentation and billing practices.
QUALIFICATIONS/GUIDELINES:
- A minimum of three years of directly relevant experience in health care compliance and/or audit, preferably in a CA health care organization, is required.
- A minimum of three years of leadership experience is also required.
- Two or more years of working full-time in a mental health setting is strongly preferred.
KNOWLEDGE/ABILITY/SKILLS:
- Experience with psychometric aspects of testing and computer applications used in technical writing, budgeting, and data analysis is required.
- It is essential to comprehend the communication methods used by community-based agencies and private practices at the county, regional, and state levels.
- You should possess a comprehensive understanding of healthcare compliance.
- Avatar EHR system knowledge is strongly preferred.
- You should possess a strong understanding of EHR systems and have the ability to become an expert user of CHC's Avatar EHR system.
- You should also possess the ability to maintain the confidentiality of information.
- Excellent customer service skills.
- You should have demonstrated excellence in both written and verbal communication.
EDUCATION/TRAINING:
- We require a bachelor's degree, but prefer a master's or higher degree in law, business, or healthcare.
- HCCA membership
- Active CHC certification
GENERAL KNOWLEDGE & SKILLS:
Knowledge of the dynamics of behavioral health disorders (BHD) and their impact upon individuals served; the social factors involved in BHD; the up-to-date principles/techniques (evidence-based/best practices) of services and their application to individuals possessing BHD; the community resources available to persons with BHD, to include crisis response, person-centered planning, psycho-educational interventions, and cognitive and behavioral therapy; knowledge of acceptable billing and service record documentation; and approaches to and skills involved in effective clinical supervision.
Skill in providing effective clinical and administrative supervision of clinical staff; the application of person-centered planning, evidence-based/best practices, and organizational policy/procedure; skill in the delivery of services using accepted treatment modalities, to include monitoring, linking, assessing, and coordinating; skill in establishing/maintaining effective relationships with individuals served and their family members; and skill in accurately documenting services provided and billed.
Ability to work within a team and lead a team; to demonstrate the application of evidence-based/best practice models, interventions, and referral techniques of services.
ADDITIONAL JOB REQUIREMENTS:
- The candidate must possess the ability to communicate effectively with other employees, the public, and individuals they serve.
- The candidate must also have reliable transportation, maintain a valid driver’s license, and maintain adequate automobile insurance.
- Travel is required as part of this position.
- Ability to operate a telephone, fax machine, computer hardware/software, etc.
- The candidate must possess the ability to write in a legible, readable, and understandable manner.
- The candidate must be willing to work in a high-stress environment where team performance is the driving force.
PHYSICAL DEMANDS/WORK ENVIRONMENT:
An employee must meet the physical demands outlined here to successfully perform the essential functions of this job. Reasonable accommodations may be provided to enable individuals with disabilities to fulfill these essential functions. While carrying out the duties of this position, the employee is regularly required to sit and use their hands. The employee frequently needs to stand, walk, use their hands, talk, and hear. Occasionally, the employee may be required to sit; reach with their hands and arms; climb or balance; stoop, kneel, crouch, or crawl; taste; smell; and lift and move up to 20 pounds. No specific vision abilities are necessary for this job.
Work Environment:
The work environment characteristics outlined here reflect the experiences of employees while carrying out the essential functions of this job. Reasonable accommodations may be provided to assist individuals with disabilities in performing these essential functions.