• Full Time
  • Le Mars

This highly compensated position primarily involves performing the duties of compliance with various regulations and rules pertaining to operations and provision of services; medical records management including but not limited to processing disclosure requests, ensuring confidentiality of client records; documentation compliance; oversee tracking of data for Compliance and Quality Improvement activities; drafting and management of policies and procedures.

Qualifications: Bachelor’s degree in healthcare administration or healthcare information or related field.  Experience with medical records, use of electronic health record and other digital media, understanding of mental health services; clientele and industry standards such as HIPAA and confidentiality of medical records, insurance and licensure and credentialing requirements.  Knowledge of medical coding, data tracking, health care regulations, policy and procedure management, and customer service experience with basic understanding of customer service essentials. Certifications in Healthcare Compliance, Healthcare Privacy Compliance preferred.  Ability to achieve certifications is required.

Essential Duties and Responsibilities:

Risk Management

  • The CCO will facilitate and continuously update an agency compliance plan to include Federal and State regulatory compliance requirements such as HIPAA, adherence to Federal & State service documentation requirements, training on Fraud, Waste, & Abuse, and OIG guidance and compliance.
  • Provide Exec Team with relevant reports of auditing, monitoring, investigations, and key program activities such as training compliance and program data.
  • Provide regular reports to the Board of Directors as directed by the CEO.
  • The CCO will oversee and participate in the Agency’s Quality Improvement Committee and report issues of quality or other concerns and work with the QI Committee to formulate QI activities around the non-compliance or risk of non-compliance.
  • Guide and work with the QI Specialist on QI projects and goals that improve adherence to relevant compliance activities.
  • Conduct periodic risk assessments to identify gaps and address new or emerging risk.  Active member of the Executive Team to inform and help guide the agency in decisions concerning compliance and risk management.
  • Oversight of records requests and disclosures and ensure processes are in place to secure and maintain confidentiality of clients PHI.

Policies and Procedures

  • Conduct routine review of agency policies and update accordingly, consulting with program managers and Executive Team as needed.
  • Develop new and or revise policies as needed to coincide with any updates or changes in federal, state, or local rules and regulations.
  • Develop and implement compliance policies and procedures to ensure compliance with federal, state rules and regulations, to include internal auditing and monitoring.

Education, Training and Communication

  • Provide annual compliance training to all new employees within 30 days of hire at a minimum, preferably on first day of new employee orientation.
  • Maintain records of all compliance training and education programs for the agency.
  • Communicate applicable regulatory changes or new requirements when necessary.
  • Maintain active involvement or membership in federal compliance websites and agencies to receive up to date information regarding compliance.

Auditing and Monitoring 

  • Develop and use relevant documentation tools within the Agency’s EHR and other sources to monitor compliance with federal, state, local and other third-party payer requirements.
  • Conduct periodic risk assessments and modify audit workplan, policies and education based on identified risk.
  • Prepare and deliver compliance program goals and work plan to the Exec Team in support of ongoing compliance monitoring.
  • Monitor the performance of the Compliance Program and related activities on a continuing basis and take appropriate action to improve program effectiveness.

Compliance Operations: Hotline/Reports, Investigations and Enforcement 

  • Maintain an effective communication for the organization including promoting use of the Compliance Hotline.
  • Conduct compliance investigations when required and facilitate discipline and/or corrective action according to policy.
  • Ensure policies, procedures and processes are in place to conduct relevant government screening all new employees and contractors prior to hire and annually thereafter, including the OIG Exclusion lists and others as required.
  • Ensure compliance standards are enforced through well publicized disciplinary guidelines.
  • Support and assist Leadership with disciplinary action for individuals that violated compliance policies.

Position location is flexible.  Travel to satellite offices and trainings may be required.

Plains Area offers a competitive salary and excellent benefits

If you are interested in joining our progressive team, send resume and Plains Area Mental Health Employment Application online below.

Please complete application at: https://plainsareamentalhealth.org/careers/application/

   E.O.E

To apply for this job email your details to application@pamhc.org