Compliance Officer

Saginaw County Community Mental Health Authority•Saginaw, MI

34d•Onsite

About The Position

Under the supervision of the Chief Quality and Compliance Officer, once successful training and certifications are completed, will serve as the Compliance Officer. In this capacity, will administer the Saginaw County Community Mental Health Authority (SCCMHA) Regulatory Compliance Program. Functions in a staff support capacity to the management team, providing research and project management. This position directs and is responsible for all subject matter related to Federal and State regulatory and contract compliance, and privacy. This person will be knowledgeable in all areas of law and statutory regulation pertaining to state and federal health care compliance. These regulations include, but are not limited to, the Michigan Mental Health Code, HIPAA, and 42 CFR Part 2. This position will be knowledgeable about and actively support culturally competent recovery-based practices; person-centered planning as a shared decision-making process with the individual, who defines his/her life goals and is assisted in developing a unique path toward those goals; and a trauma-informed culture of safety to aid the persons served in the recovery process.

Requirements

Master’s degrees in: Business, Applied Science, Criminal Justice, Public Health, Health Administration, Social work, Psychology, or a closely related Human Services field, or another related field may be considered.
Five (5) years of progressive mental health experience preferred. Five (5) years of experience in compliance, criminal justice, and civil rights.
General knowledge of applicable federal and state laws and regulations in any of the related subject matter. Working knowledge of the Michigan Mental Health Code. Knowledge of the Federal Register, MDHHS Medicaid Manual, L Letters, the Office of the Inspector General (OIG), the Michigan Department of Health and Human Services (MDHHS), and other key regulatory agencies.
Must possess or acquire within 2 years and maintain a Certification in Healthcare Privacy Compliance (CHPC) and a Certification in Healthcare Compliance (CHC) or other Compliance-related certifications that are applicable to the position and approved by the CIO/CQCO.
Valid Michigan Driver’s license with good driving record.
Considerable knowledge of applicable state and federal legislations, Michigan rules and regulations and the Michigan Mental Health Code.
Ability to establish and maintain effective working relationships with persons served and families, community mental health personnel, contracted agencies, and state and community representatives.
Excellent oral and written communication skills and sound computer skills.
Ability to lead and manage moderately complex projects.
Hearing acuity to converse in person and on telephone.
Visual acuity to read and proofread documents and use CRT.
Ability to walk, stand or sit for extended periods of time.
Manual dexterity to write and to operate standard office equipment (PC, Keyboard, Copy Machine, Fax Machine, etc.)
Ability to lift and carry files and supplies at least 20 pounds.
Strong interpersonal skills to interact with leadership, employees, persons served, and the general public.
Analytical skills necessary to conduct research, analyze, and interpret complex data and identify and solve problems by proposing courses of action.
Ability to plan short and long range and to manage and schedule time.
Ability to handle stress in meeting deadlines and dealing with large numbers of employees and or/persons served.

Responsibilities

Maintains information links with primary and secondary sources of federal and state regulatory publications, analysis, and review in all areas of SCCMHA regulatory risk exposure. Establishes a routine of scanning and reading the Federal Register, the website of the Office of the Inspector General (OIG), and key regulatory agencies, industry journals, electronic news services, association newsletters, and conferences.
Acts as Compliance Officer to support regulatory compliance management. Maintains compliance system expertise and general knowledge of specific regulatory topic areas, including managed care, healthcare finance, privacy, security, accreditation, quality, information systems, and contracts. Maintains a consultation network for topic-specific information and provides referrals for division directors.
Serves as HIPAA Privacy Officer, responsible for maintaining corporate compliance with regard to HIPAA and HITEC regulations. Works closely with the CIO/CQCO, who serves as HIPAA Security Officer. Ensures the posting of SCCMHA HIPAA privacy notice throughout the network and coordinates procedures for responding to persons served and provider access to Protected Health Information.
Serves as Hearing Officer for Medicaid Fair Hearings, coordinates document submission to MDHHS and MSHN, and facilitates hearing proceedings. Participates in periodic MDHHS technical assistance sessions for Hearing Officers.
Reviews Notices of Proposed Rule Making (NPRM).
Performs intake and facilitates the assessment of new regulations as published.
Initiates application project planning and implementation monitoring.
Maintains primary source reference library for all existing regulations and monitors sources for updates, revisions, and amendments. Notifies all directors of such matters as they are published and initiates the intake, assessment, and planning of modifications as applicable.
Performs regulatory risk assessment and facilitates prioritization of activities in an annual compliance plan, which is comprehensive of all regulatory scopes of compliance.
Provides project planning support to compliance workgroups. Receives and files workgroup documentation. Monitors workgroup documentation and provides guidance in necessary elements for documentation quality.
Administers the Compliance Hotline and reporting capacity. Receives and responds to hotline concerns, documents, tracks, and trends hotline reports.
Implements and facilitates periodic testing in all regulatory topic areas according to the Annual Compliance Plan, including privacy, security, claims payment timeliness, claim coding integrity, etc.
Works with SCCMHA Training Department to assess staff and network training needs and incorporates training plan in annual compliance plan. Implements continuous training in compliance topics throughout the agency and provider network. Collaborates with SCCMHS Training Dept to maintain documentation of training provided.
Prepares reports of testing results and forwards these to the quality improvement program team for process improvement initiatives.
Monitors compliance outcome indicators and prepares reports for the quality improvement program team.
Works with the Management Team to formulate response and prevention when adverse findings are identified by internal or external audit, SCCMHA Fraud and Abuse Hotline report, or other authorized governmental inquiry or their sanctioned agent.
Implements and is responsible for the agency’s compliance plan under the direction of the CIO/CQCO.
Mitigates all risks identified in the compliance risk assessment.
Develops agency-wide role-based compliance training.
Makes recommendations to the CIO/CQCO on developing and evaluating the Grievance and Appeal training plan.
Attend compliance-related meetings as directed by the CIO/CQCO.
Serve as a member of the Leadership Team, developing collegial, supportive relationships with other members, using professional skills to develop shared vision and team learning, and effective management throughout the organization. Provides administrative leadership within the Leadership Team to promote an integrated organizational vision and mission.
Represents SCCMHA with various local, regional, state, and national groups as appropriate to meet organizational goals and objectives.
Communicates the mission, vision, and core values of SCCMHA to staff while holding them accountable and implements these principles in all duties of this position.
Performs other duties as assigned by the CIO/CQCO.