Summary

This position is responsible for compliance processes and primary medical records oversight. Prepping and facilitating external audits with MCO, DSS, DHSR and IAFT providers. Quality Assurance, prepping and facilitating internal reviews of client and foster parent files. Tracking and follow-through of any internal/external Plans of Corrections. Development, review and revision of policies and procedures.

HYBRID - IN OFFICE - REMOTE options for this role

GREAT BENEFITS ~ FLEXIBLE PAID TIME OFF ~ OPPORTUNITIES FOR GROWTH ~ WORK -LIFE BALANCE

Principal Duties and Responsibilities

Compliance Processes

Be knowledgeable of all policies, rules and procedures for foster care services, outpatient, community-based programs, day treatment services, and enhance services based on NC General Statues and Administrative rules of The North Carolina Department of Health and Human Services from a compliance viewpoint.

Develops timelines and action plans to assure readiness and a system of checks and balances to assess compliance for any audit.

Monitors the implementation and adherence to POC's through monthly/quarterly file reviews in accordance to CHA policy.

Compiles and analyzes documentation and provides audit information to department management to prepare for DSS, DHSR, MCO, IAFT, and other audits under the rules of The North Carolina Department of Health and Human Services.

Provides training and ongoing support to enhance the quality of documentation and care reflected therein.

Provides consultation and guidance regarding compliance processes to ensure all agency employees understand and are efficient within compliance rules and regulations.

Reports regular compliance updates, and readiness feedback to compliance manager and executive management detailing audit results and any recommendations for compliance program improvements.

Medical Records Oversight

Be knowledgeable of all policies, rules and procedures for foster care services, outpatient, community-based programs, day treatment services, and enhance services based on NC General Statues and Administrative rules of The North Carolina Department of Health and Human Services from a compliance viewpoint.

Develops quarterly audit plan/schedule, preps and conducts routine internal reviews and audits of client files and foster parent files.

Develops and utilizes a tracking mechanism to collect and coordinate agency documentation to ensure proper filing and storage in Laserfiche and EHR is completed in a timely manner.

Develops, installs, and communicates, in collaboration with the Compliance Department, Plans of Correction for out of compliance findings

Completes follow-up reviews to ensure corrections have been made.

Reports results of review to appropriate department managers in a timely manner

Develops and provides training and ongoing support for current EHR that correlates with medical records to enhance the quality of documentation and care reflected therein.

Provides consultation and guidance to ensure all agency employees understand and are efficient with medical record processes.

Eternal Audits

Be knowledgeable of all policies, rules and procedures for foster care services, outpatient, community-based programs, day treatment services, and enhance services based on NC General Statues and Administrative rules of The North Carolina Department of Health and Human Services from a compliance viewpoint.

Prepping and facilitating external audits with MCO, DSS, DHSR and IAFT providers. Back-up to Compliance Manager for Accreditation Reviews.

Works collaboratively with other compliance coordinators to create plans of correction with programs.

Reports results of POC to appropriate department managers in a timely manner

Provides consultation and guidance directly with external providers.

Development, Review and Revision of Policies and Procedures

Be knowledgeable of all policies, rules and procedures of foster care, outpatient, community-based services, day treatment services, and enhanced services based on NC General Statues and Administrative rules of The North Carolina Department of Health and Human Services to maintain and revise agency forms as needed.

Works collaboratively with Chief Compliance Officer, and Compliance Manager to develop, review, and revise policies, procedures, and forms to help ensure accuracy, consistency, clarity, and compliance.

Assists in the communication of new and/or revised/reviewed policy, procedure, and forms so all departments are aware of change.

Provides training and ongoing support to enhance the quality of documentation and care reflected therein.

Education and Experience Requirements

• 
  Associates Degree (A.A.) or equivalent from two-Year College or technical school; two years related experience and/or training; or equivalent combination of education and experience preferred.
• Knowledge of and professional experience with Medicaid rules and requirements, HIPAA, and other applicable licensing and accreditation requirements
• 1-2 years of auditing or related quality assurance experience preferred
• Demonstrate proficiency in MS Office software, including Word, Excel, Outlook, and PowerPoint
• Detail-oriented and well-organized

Children's Hope Alliance is an Equal Opportunity Employer