This Manager acts as a compliance and regulatory resource to company owned locations and the franchise network. This position supports internal compliance, HIPAA and federal/state Medicaid and Medicare compliance programs as well as the quality provision of care and services to clients, including companionship, homemaking, personal care, Private Duty Nursing, technology-based services and certain piloted services.
The position supports company operations and the franchise network in the areas of regulatory compliance including research, development, implementation and training of policies and procedures based on federal and state licensure regulations, accreditation standards, payor source requirements and recognized standards of care required in the normal course of doing business. This role also involves overseeing the monitoring, analyzing, and reporting of Quality Assurance audit results, including development and implementation of performance improvement plans.
This Manager is responsible for the coordination of the licensure and change of ownership processes for mergers and acquisitions of new business locations, as well as accountable for the application process, renewal process, change in administration requirements, change of address requirements and other licensure related tasks. The role supports the inspection/survey process and develops the plan of correction with administrative staff and requires working with internal partners for marketing, learning and development and HR issues as related to rules and regulations. This position requires monitoring of laws changes and implementing policy and procedure changes as indicated.
The position supports the company’s ethical and privacy and compliance programs. This position reports to the Assistant General Counsel, Vice President, Ethics and Privacy, and works closely with senior and executive management, as well as all employees, as appropriate, for each operating division and department. The position is responsible for maintaining and initiating ethics and privacy initiatives and addressing compliance matters and concerns and managing projects, including communication, training and awareness projects. The position provides guidance Company-wide, written and oral, on ethics and privacy matters including research, analysis and advice on ethics concerns and company policies. This position acts as Secretary for important committees such as the legal Ethics and Compliance Committee, the CP Governance Committee, and the Privacy Working Group. This position assists in supporting special investigations and analysis of same, and manages the department’s reporting and quality assurance process. This position manages the ethical conduct survey project, a cornerstone of the company’s legal and ethical compliance program.
- Responsible for submission and upkeep of state licensure applications, renewals and updates, Medicaid applications, insurance compliance and standards, and other regulatory requirements as needed.
- Will serve as Chief HIPAA Compliance Officer
- Responsible for Medicare and Medicaid compliance and certifications.
- Supports implementation and compliance with regulatory standards during the survey process; creates and monitors plan of correction.
- Works closely with the finance teams, inside legal team and others to facilitate mergers and acquisitions.
- Responsible for training as needed.
- Ensures compliance to regulatory and CKFI quality standards
- Monitors effectiveness of policies and procedures with an emphasis on cost saving initiatives
- Responsible for oversight of the Sodexo Quality Assurance committee and ongoing auditing processes.
- Leads the Private Duty Nursing program, providing training and compliance resources
- Provides recommendations on Sentinel events, complaints and policies
Education & Experience:
- Bachelor’s Degree in related field preferred
- Registered Nurse and Certification in Healthcare Compliance preferred
- 7+ years' experience in related field
- 3 years' experience in project management
- 5 years' experience in leadership/management
- Understanding of the legal and regulatory framework governing the Home Care industry
- Ability to work with all levels of management on potentially complex compliance/regulatory issues
- Excellent communication skills
- Superior interpersonal communication skills
- Strong writing skills required to write and edit policies and procedures, compliance reports, and other communications
- Works well independently
- An engaging and informative teacher for Operations team members
- Possesses and conveys high degree of credibility and integrity
- Understands and accepts the unpredictable nature and needs of the compliance function
- Exhibits analytical skills and an understanding of operational processes