Director of Quality Improvement and Corporate Compliance - Achieve of NY : Job Details

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Job Type

Full-time

Description

Director of Quality Improvement and Corporate Compliance

Full Time, on-site

Salary $60,000-$85,000 /yr

The Director of Quality Improvement and Corporate Compliance is responsible for administrative oversight of the Quality Improvement, Incident Reporting, and Corporate Compliance Programs at ACHIEVE. The Director of Quality improvement and Corporate Compliance assumes responsibility for internal and external auditing functions as well as oversight of the Agency's investigation process, including the integrity of all reports produced by Trained Investigators and mandatory reporting to New York State. The Director of Quality Improvement and Corporate Compliance is responsible for implementation of an effective Corporate Compliance Program. Duties and responsibilities include but are not limited to:

* Oversee and monitor the development/implementation of the Agency corporate compliance program and act as Chairperson for the Agency's Internal Corporate Compliance Committee.

* Maintain oversight of internal Medicaid billing audits across all agency programs to ensure compliance with Medicaid billing standards.

* Maintain current knowledge of applicable federal and state privacy laws and accreditation standards, and monitor advancements in corporate compliance to ensure agency compliance.

* Ensure Medicaid compliance including development and implementation of agency policies and procedures, documentation and billing standards, and internal audits.

* Establish and maintain a reporting channel system to receive complaints and ensure effective lines of communication between the Compliance Officer and all employees. Ensure confidentiality providing anonymity of complaints and protecting those who report from fear of retaliation.

* Investigate allegations of breach of corporate compliance policies and procedures and enforce disciplinary standards through established guidelines.

* Maintain oversight of training partner and business associate agreements to ensure compliance requirements and responsibilities are met.

* Work with program staff to respond to POCA's (Plans of Corrective Action), as needed

* Coordinate Agency's Quality Improvement Program ensuring both individual and program outcomes evidence best practices and high-quality care for individuals supported at ACHIEVE

* Provide oversight to agency Incident Reporting systems including compliance with NYS OPWDD and Justice Center requirements as it applies to incidents/investigations

* Represent agency on statewide initiatives related to job responsibilities and as requested

* Work with agency departments to assist with compliance with governmental regulations and agency policies and procedures.

* Provide for a system of oversight to ensure that independent contractors and agents who furnish physician, nursing or other clinical health care services to individuals served, or are billing for services to the agency, are aware of the requirements of the agency compliance program.

* Complete and/or approve required documentation in compliance with rules, regulations, policies and procedures and billing practices

* Perform documentation reviews to ensure records are maintained in conformance with rules, regulations, policies, procedures and billing practices

* Facilitate development of corrective action steps/plans to address identified trends and patterns.

* Conduct audits of agency programs and records to ensure that services are being provided in compliance with regulations policies and acceptable standards of practice.

* Cooperate with the Office of Inspector General, other legal entities and ACHIEVE and NYSARC administration in compliance with reviews or investigations.

* Coordination of external audit process during on-site visits and exit conferences, provide assistance to program management and completion of Plans of Corrective Action.

* Provide agency training in areas of expertise

Requirements

A minimum of a Bachelor's Degree in a Human Service or Related Field with a minimum of two years of supervisory oversight as well as three years working with the OPWDD population - OR - A combination of education and experience that in the opinion of the reviewing agency, exceeds the above standards of the program

A valid drivers license and record acceptable to the agency's insurance carrier

Salary Description

$60,000-$85,000