Compliance Generalist

WESTERN RESERVE AREA AGENCY ON AGING•Cleveland, OH

4d•$0 - $68,000

About The Position

Western Reserve Area Agency on Aging (WRAAA) is a private non-profit corporation, organized and designated by the State of Ohio to be the planning, coordinating and administrative agency for federal and state aging programs in Cuyahoga, Geauga, Lake, Lorain, and Medina Counties. It is one of twelve Area Agencies on Aging (AAAs) in the state organized with local service provider organizations and the Ohio Department of Aging (ODA) to form the state's public aging services network. The network works together to create opportunities for older Ohioans to receive needed home and community services and support; and to age successfully in their own homes and communities. Position Summary: The Compliance Generalist is a Registered Nurse (RN) or Licensed Social Worker (LSW or LISW) who utilizes clinical knowledge to determine, through case reviews, the Agency’s compliance with program and regulatory requirements. The Compliance Generalist also compiles and analyzes data related to assessment, care management, and other services to assist with identifying and resolving areas of potential compliance risk, including HIPAA violations and Fraud/Waste/Abuse.

Requirements

Current unrestricted licensure as a RN or LSW within the State of Ohio.
Must have solid clinical background (at least 2 years); experience in home health or field case management preferred.
Must have strong organizational skills with accuracy and keen attention to details.
Must have strong analytical skills with a working knowledge of statistics.
Must have excellent interpersonal and business communication skills.
Must be able to communicate collaboratively with others and maintain good working relationships.
Must be proficient with relevant software programs and computer applications, including Microsoft Office applications (Word, Excel, Outlook, PowerPoint, Teams) for word processing, graphics, spreadsheets, databases, email, and use of the Internet to research and create documents and materials.
Ability to use and be trained in multiple databases.
Must have a car available during working hours, as well as the ability to legally drive a car.
Ability to independently identify, research and resolve issues.
Must be a self-starter with demonstrated ability to work under minimal supervision in a remote or hybrid setting.
Ability to sit for prolonged periods.
Ability to lift up to 25 lbs., or equivalent of briefcase containing laptop and accessories.

Responsibilities

Serves as clinical and compliance subject matter expert.
Evaluates cases for compliance with contractual and federal/state regulatory requirements, utilizing critical thinking skills and sound clinical judgment.
Develops, initiates, maintains, and revises policies and procedures related to general operation of Compliance Program for assigned programs.
Provides post audit findings and recommendations to ensure fulfillment of contractual program and compliance standards.
Identifies potential areas of compliance vulnerability and risk. Collaborates with the Senior Compliance and Privacy Officer and other departments (e.g., Case Management) to develop corrective action plans for resolution of issues and provides general guidance on how to avoid or mitigate similar situations in the future based on regulatory requirements and clinical experience.
Provides reports as directed to keep the Senior Compliance and Privacy Officer, Compliance Committee and/or senior management informed of the operation and progress of compliance efforts.
Demonstrates ability to manage multiple competing priorities effectively by maintaining established timeframes, adhering to deadlines, and communicating changes effectively.
Maintains minimum proficiency in all requisite computer applications and software.
Maintains consumer confidentiality according to HIPAA regulations and Agency policy.
Participate in trainings, meetings, in-services, and continuing education opportunities required per regulations and by the Senior Compliance and Privacy Officer.
Performs other related duties as assigned.
Abides by the professional code of ethics established by licensure.
All staff have the responsibility and authority to propose ways to improve quality and to fully participate in quality improvement efforts.