FACHC



Compliance Director - FoundCare Inc., is looking to place you in the position of Compliance Director.Share your knowledge, skills and training with us, and you will be rewarded greatly, in areas of salary benefits, and employee relations.Apply today and provide these essential functions:Review all agency contracts to ensure municate contract deliverable to responsible staff.Track contract amendments/expiration dates/renewal datesReview, analyze, and summarize all Managed Care and MSO contracts and terms.Review, analyze, and summarize all reports sent to the agency, from Managed Care companies and MSO’s related to HEDIS, and all other quality indicators, to ensure compliance.Work with clinical leadership to ensure clinical teams develop a process to meet the requirements of the Managed Care and MSO contracts.Review EMR to ensure set up appropriately captures the data points necessary to report to the Managed Care and MSO companies.Provide clinical guidance on how to improve on all measures.Lead and submit the Federal Torts Claims Act (FTCA)?Application?annually.Lead and submit the Volunteer Federal Torts Claims Act (FTCA) Application annually.Ensure the Risk Plan is properly implemented to mitigate corporate-wide risk.Review policies and procedures to ensure contractual compliance.Develop and implement an effective compliance program.Proactively audit processes, practices and documents to identify weaknesses.Create sound internal controls and monitor adherence.Carry out assessment of healthcare compliance policy and procedure and assist in updating or developing new policies to enhance operations and/ or internal controls or consider new areas.Carry out risk analysis on healthcare compliance, discover areas of potential compliance risk and vulnerability, and create and implement solutions to eliminate the potential risks.Supervise compliance training in HIPAA, and related federal and state laws to get employees informed on ethical and legal standards.Work with?Pharmacy?Director to ensure compliance with the 340B Program.Ensure compliance with the Health Resources and Services Administration Program Requirements.Work closely with others in related departments, including, HR, IT, and Finance for effective investigation, resolution, reporting, and remediation of compliance issuesServe as the HIPAA Privacy OfficerPrepare report for management on incidents, investigations, and all compliance issuesBe informed of current legislation and enforcement issues affecting the healthcare industry, as well as compliance best practicesLead Patient Centered Medical Home(PCMH) initiatives, and ensure that the agency remains compliant with all PCMH requirements.REQUIRED KNOWLEDGE, SKILLS AND ABILITIES:Strong clinical analytical and problem-solving skills.Ability to query systems, abstract data, and create meaningful reports using data queries.Detail oriented, while work product has a very high level of accuracy.Strong written and communication skills.Strong Electronic Medical Record experience.Experience and ability to initiate, develop, maintain, and review policies and procedures for the operation of a healthcare compliance program and other similar activities to mitigate corporate risk.Healthcare compliance evaluation and auditing experience to be able to discover operational problems and recommend and execute strategies to provide needed solutionStrong ability to prioritize and perform multiple projects concurrently.Strong knowledge of Excel, PowerPoint, and Electronic Medical Record Systems.Proven ability to collaborate and advise management on compliance matterAbility to develop practical business solutions and to facilitate risk assessmentif you are this candidate and you meet the MINIMUM QUALIFICATIONS, apply today and continue your stellar career in the healthcare industry.Eight (8) years health care management and/or health care risk/compliance experience.Bachelor’s degree in Health Sciences or related field (Master’s Degree preferred).Experience in Quality Improvement/Risk Management.Experience in project management and/or performance improvement.Experience with monitoring and trending data required.Experience in population health management.Experience with HEDIS measures.Experience dealing with regulatory and granting agencies.Experience with Federal Torts Claims Act (FTCA) application/process.Experience with Patient-Centered Medical Home (PCMH).Experience with Managed Care contracts.Experience working with Electronic Medical Records required.Possess superior organizational, interpersonal, written/verbal communication skills.Effective communication and motivational techniques for one-on-one and in public presentation to diverse audiences.Flexible schedule, allowing for weekends or evenings as needed.PC proficient.Valid Florida driver's license, automobile insurance and reliable automobile ................
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