Director of Compliance

Location

Berkeley, CA | United States

Job description

LifeLong Medical Care is s eeking a Director of Compliance. The Director provides overall professional direction, oversight, and guidance for LifeLong Medical Care’s (LMC) compliance, including but not limited to clinical, program, and administrative departments. The Director is responsible for ensuring compliance with Federal and State accrediting and licensing standards, as well as relevant federal, state, and local laws and regulations.

This is a full time, exempt, benefit eligible position. 

LifeLong Medical Care is a large, multi-site, Federally Qualified Health Center (FQHC) with a rich history of providing innovative healthcare and social services to a wonderfully diverse patient community. Our patient-centered health home is a dynamic place to work, practice, and grow. We have over 15 primary care health centers and deliver integrated services including psychosocial, referrals, chronic disease management, dental, health education, home visits, and much, much more. LifeLong Medical Care is an equal opportunity employer. We strongly encourage applications from women, people of color, and bilingual and bicultural individuals and members of the lesbian, gay, bisexual, and transgender communities. Applicants shall not be discriminated against because of race, religion, sex, national origin, ethnicity, age, disability, political affiliation, sexual orientation, gender identity, color, marital status, or medical condition.

Benefits

Compensation: $130k - $160k/year. We offer excellent benefits including: medical, dental, vision (including dependent and domestic partner coverage), generous leave benefits including ten paid holidays, Flexible Spending Accounts, 403(b) retirement savings plan.

COVID-19 Vaccine Policy

In accordance with LifeLong Medical Care's commitment to provide and maintain a workplace that is free of known hazards, we have adopted a Mandatory COVID-19 Vaccine Policy to safeguard the health of our employees and their families; our patients and visitors; and the community at large from infectious diseases, that vaccinations may reduce. This policy will comply with all applicable laws and is based on guidance from the Centers for Disease Control and Order of the California State Public Health Officer. Unless a reasonable medical or religious accommodation is approved, all employees must receive COVID-19 vaccinations.

The Director of Compliance develops LMC’s corporate compliance plan and oversees and monitors the implementation of the plan and the compliance program. Typical duties include but are not limited to:

• Oversees a corporate compliance program, develops and maintains a written corporate compliance plan and annual evaluation of the plan’s effectiveness; ensures that all required elements of a compliance program are addressed.
• Manages LifeLong’s compliance and risk management programs, including but not limited to ensuring compliance with HIPAA Privacy and Security Act, Federal Tort Claims Act, federal Community Health Center Regulations, and state licensing regulations.
• Designs, implements and improves processes to prevent, detect and respond to compliance issues and concerns related to all federal and state regulatory requirements and contract requirements.
• Works collaboratively throughout the organization in a leadership, advisory and facilitative capacity utilizing compliance staff, interdepartmental teams, and training systems to achieve corporate compliance, quality improvement, and risk management goals and objectives.
• Manages LifeLong’s incident report system including tracking of incidents, working with other LifeLong managers and department leads to resolve incidents, and reporting to LifeLong insurance carriers as necessary.
• Serves as designated HIPAA Officer and Risk Manager for the agency. Investigates potential incidents pertaining to HIPAA; billing and reimbursement; and allegations of fraud, abuse, conflict of interest, suspected or actual breaches of privacy, confidentiality, and security.
• Serves as LMC’s Federal Tort Claims Act (FTCA) Risk Manager and works with the Chief Administrative and Medical Officers on all FTCA-related activities, including annual assessments and required training for staff and Board.
• Investigates and evaluates claims and potential claims.
• Collaborates with the Chief Medical Officer (CMO) in the investigation of clinical events including sentinel events, sentinel event near misses, and significant adverse events; leads and/or participates in the development of root cause analyses as directed by the CMO.
• Oversees the annual review of LifeLong’s policies and procedures, in collaboration with policy owners and executive reviewers.
• Manages and administers contract operations with support from other departments for contract review, such as legal, finance and clinical departments.
• Manages the coordination of external/internal inspections and audits with Clinic Directors and Facilities to ensure regulatory compliance. Works with Clinic Directors to address corrective actions.
• Analyzes the findings from any internal or external audits and programmatic site visits to assess compliance with applicable laws, regulations, and standards. Works with impacted programs, departments, or sites to address and remediate findings.
• Conducts, supervises, or coordinates internal investigations of alleged compliance violations.
• Represents LMC in compliance-related work groups convened by local and statewide bodies.
• Develops and maintains up-to-date knowledge of corporate compliance requirements and related laws and regulations as mandated or recommended by HRSA, OIG, CMS, and other agencies; attends outside corporate compliance trainings provided by NACHC and/or other agencies as directed by the Chief Administrative Officer.
• Hires, evaluates, and supervises the Compliance Program Manager, Compliance Specialist and Compliance and Privacy Specialist.
• Participates on the Quality Improvement Committee.
• Coordinates with CEO or their delegate on the composition and delivery of responses to regulatory agency complaints and inquiries.
• Advises CEO and CAO on Policy Advocacy issues at State and Federal levels.
• Performs other duties as assigned.

• Education: Bachelor’s degree in Healthcare Administration, Public Administration or related.
• Minimum of 5 years of compliance, legal, clinical, risk management or relevant work experience.
• Federally Qualified Health Center experience.
• Familiar with operational, financial, quality assurance, and risk management procedures regulations
• Commitment to the provision of health services for the underserved with demonstrated ability and sensitivity in working with a variety of people from low-income populations, with diverse educational, lifestyle, ethnic and cultural origins. Interest in health policies which support the work of the health center.
• Knowledge of compliance, reimbursement, and other requirements as well as all regulatory agencies pertaining to community health centers.
• Ability to effectively support, motivate and supervise staff, encourage and nurture development and growth, to build a strong and productive team.
• Strong organizational, administrative, multi-tasking, prioritization and problem-solving skills.
• Ability to work effectively under pressure in a positive friendly manner in a eam-oriented environment and to be flexible and adaptive to change.
• Excellent interpersonal, verbal, and written skills.
• Be creative and mature with a “can do”, proactive attitude and an ability to continuously “scan” the environment, identifying and taking advantage of opportunities for improvement.

Job Requirements

• Supervisory experience a plus
• Proficient in Microsoft Office, Word, Excel, Outlook

Job Preferences

• Master’s Degree
• Certification in Health Care Compliance (CHC)
• Bi-lingual

Job tags

Salary