Overview
Oversees the day-to-day implementation of the Compliance Plan and carries out compliance initiatives with the agencies that the Compliance Director oversees. Assists the VP of Compliance with prevention, detection, and follow-through activities to assure compliance with all legal and regulatory statutes. Promotes a culture of compliance by modeling honest and ethical behavior, and through relationship building with agency leaders and clinical staff.
Responsibilities
• Identifies and mediates compliance risk areas in relation to local, state, and federal regulations.
• Monitors implementation of the Compliance Program and make regular reports to the VP of Compliance, also communicating trends, concerns and areas of risk to VPs of Operations and local Administrators.
• Assists with the development, evaluation, and implementation of policies, protocols, and initiatives, based upon identified and/or potential areas of risk and governmental focus on compliance issues.
• Assists with review, revision, and evaluation of the company's compliance program as necessary to meet the changing needs of the organization in its business and regulatory environment.
• Conducts mock surveys and assist agencies in survey preparation and response.
• Coordinates with billing, human resources, and other departments on matters of regulatory compliance.
• Provides compliance education and support to local clinical leadership to ensure compliance functions are understood and implemented within the agency, promoting an understanding and culture of compliance.
• Conducts independent (scheduled and ad hoc) field and desk compliance reviews/audits to evaluate and monitor compliance with standards and procedures implemented by the Company and duties imposed by state and federal laws and regulations.
• Evaluates requests for documents and records from government agencies, payors and other third parties. Gather, submit and track requested documentation. Communicate regarding requests with VP of Compliance, agency leadership and billing counterparts.
• Stays abreast of laws and regulations relevant to Company operations.
• Flexibility to assist in ad hoc projects and available to travel; available to provide job duties for multiple states/agencies.
Qualifications
• Registered Nurse with current license in good standing
• 8 years of experience in health care, preferably in home health, rehab or hospice. One (1) year of experience in regulatory compliance preferred.
• Knowledge of state and federal statutes, rules, and regulations and accreditation requirements as applicable to home health and hospice, including applicable fraud and abuse laws.
• Experience with state, CMS and accrediting body surveys, including writing and implementing plans of correction for survey citations.
• Strong analytical skills, including an understanding of how to use data metrics.
• Familiarity with Home Care Home Base, Well Sky or other electronic health record and its reporting and analytics features preferred.
• Understanding of the seven elements of an effective compliance program.
• Certification in Basic Healthcare compliance a plus, or willingness to obtain certification.
• Demonstrates good verbal and written communication and public relations skills.
• Demonstrates autonomy, organization, assertiveness, flexibility, and cooperation in performing job responsibilities.
• Must be able to travel overnight to different work-related locations. Travel can be up to 50%.
