Compliance Coordinator jobs at Aspen MP - 1391 jobs
Clinical Compliance Manager
Baymark 4.0
Lewisville, TX jobs
at BayMark Health Services Full Time - Compliance Manager BayMark Health Services is looking for a detail-oriented and conscientious Compliance Manager to provide auditing and regulatory oversight to programs under the direction of the Chief Clinical Compliance Officer.
Responsibilities:
Manage and maintain compliance with federal and state rules, regulations, laws and standards for BayMark clinic operations.
Performs audits of clinical services, develops auditing tools, and serves as point of contact for auditors, and oversees compliance with corrective action plans.
Maintains current knowledge of rules, regulations and disseminates regulatory and legislative updates.
Partner with Chief Clinical Compliance Officer in the development and/or revision of policies and procedures on state and federal rules and regulations.
Alert management to deficiencies or serious non-compliance issues that have potential for high risk.
Assists as requested with compliance/policy and procedural development for new and acquired clinics.
Participation in the company performance improvement process, partners with clinic directors to meet objectives, and provides management reporting
Other duties, as assigned.
Qualifications:
Minimum 2 years' college. Bachelors or Master's degree preferred.
Nursing or Counseling licensure/certification preferred; prior
Compliance experience
Experience with the survey process of a health care services operation including JCAHO, CARF, Medicare, and/or state licensing survey process.
Understanding of clinic operations
Understanding of HIPAA, Federal, State, CARF and/or JCAHO standards and regulations.
Knowledge and skills of Microsoft products with strong proficiency with Excel.
Excellent interpersonal and communication (both verbal and written skills.)
Self-motivated with ability to work in an interdisciplinary setting.
Ability to work with little supervision and demonstrated organizational skills.
Satisfactory drug screen and criminal background check
Ability to travel 50% - 70%.
Benefits:
Competitive salary
Comprehensive benefits package including medical, dental, vision and 401(K)
Generous paid time off accrual
Excellent growth and development opportunities
Satisfying and rewarding work striving to overcome the opioid epidemic
Here is what you can expect from us:
BayMark Health Services specializes in the treatment of opioid addiction. BayMark Health Services provides medication-assisted treatment services in a variety of modalities and settings through our divisions: BAART Community HealthCare, Health Care Resource Centers and MedMark Services, Inc. BayMark Health Services, also provides traditional primary health care services, as well as integrated primary care, in select locations.
BayMark Health Services is committed to Equal Employment Opportunity (EEO) and to compliance with all Federal, State and local laws that prohibit employment discrimination on the basis of race, color, age, natural origin, ethnicity, religion, gender, pregnancy, marital status, sexual orientation, citizenship, genetic disposition, disability or veteran's status or any other classification protected by State/Federal laws.
$70k-104k yearly est. 4d ago
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Compliance and Privacy Manager - JD
Atlantic Health 4.1
Morristown, NJ jobs
The Compliance and Privacy Manager oversees, in pertinent part, the following compliance risk areas: (i) general compliance and compliance program effectiveness; (ii) fraud, waste and abuse and Deficit Reduction Act of 2005 workforce member and contractor compliance; (iii) patient and employee confidentiality, organizational privacy, information governance, and data risk classification; (iv) accountable care organization compliance; (v) Medicare C & D/Medicare Advantage compliance program requirements; (vi) Federal healthcare program compliance; and (vii) other assigned risk areas identified through organizational experience, risk identification activities, or regulatory mandates.
The Manager will support the Director of Corporate Compliance to ensure implementation of appropriate policies and procedures, support compliance training, conduct investigations.
Perform compliance program effectiveness reviews based on the seven (7) elements of an effective compliance program as set forth in: (i) relevant U.S. Department of Health and Human Services compliance program guidance; (ii) U.S. Sentencing Commission Guidelines Manual; (iii) U.S. Department of Justice, Criminal Division, compliance program guidance; (iv) CMS Conditions of Participation; (v) Medicare Shared Savings Program Accountable Care Organization Compliance guidance and regulatory requirements; and (vi) Medicare C & D/Medicare Advantage compliance program requirements.
Maintain a system of reporting and ensure the integrity of all compliance investigations, direct and coordinate internal audits, and monitor HIPAA/Patient Privacy compliance.
The Manager ensures that the Compliance Program effectively promotes prevention, detection, and resolution of instances of improper conduct to ensure conformity to state or federal laws, regulatory requirements, hospital policies, patient privacy, IT Security or the standards of conduct.
The Manager will be responsible for following up on reported incidents of non-compliance, conduct and or coordinate internal investigations and prepare reports on the incidents and investigation findings.
The Manager will be responsible for assessing compliance of the organization's policies and assist in updating or developing new policies.
The Manager will assist in evaluating areas of potential billing, Stark, Anti-kickback compliance or patient privacy risk and collaborate with other managers within the organization to work with management to implement solutions to eliminate potential risks.
Manage and investigate compliance questions, complaints, and reported incidents in collaboration with management, legal and human resources, as needed.
Responsible for Compliance Program data analytics to develop reports for monitoring and auditing, case management and federal reporting.
Responsible for developing organizational wide compliance communication plan, communications, and training programs.
Coordinate HIPAA Security compliance activities with the AH HIPAA Security Officer/Information Security Officer.
Investigate HIPAA-related complaints and draft corresponding reports.
Draft responses to HIPAA-related regulatory inquiries.
Review business associate agreements, data use agreements, and limited data set agreements and ensure said agreements are acceptable as to compliance form and meet standard form internal requirements.
Conduct risk assessments and audits pertaining to assigned compliance risk areas.
Conduct compliance and privacy training and education.
Prepare PowerPoints and present educational or compliance-related topics to AH constituents.
Draft compliance and HIPAA-related policies and procedures, as well as policies and procedures related to other assigned risk areas.
Assist in conflict-of-interest reviews, evaluations, and determinations.
Assist in conflict-of-interest endorsement requests reviews.
Qualifications:
• Education: A Juris Doctor degree from an ABA accredited law school and admission to the bar to practice law in one of the 50 States (or Washington, D.C.) of the U.S. is required. The holding of a Master's Degree in public health, healthcare, accounting, allied health, clinical-related studies, compliance, audit, computer science, finance, education, law, privacy, information security, information governance, or another field related to the responsibilities of the position at hand, is a plus.
• Certifications: Candidates who hold the “CCEP” or “CHC” designation from the Compliance Certification Board are strongly preferred. Any successful candidate who does not hold the “CHC” designation at the time of appointment will be required to obtain the same within 12 months of appointment. A successful candidate must obtain either the “CISA”, “CRISC”, or “AAIA” designation from ISACA within eighteen (18) months of employment.
Experience:
• Five years minimum of health care compliance experience, health care administration, legal, fraud, waste, and abuse; internal audit, organizational compliance, regulatory affairs or a filed related to the responsibilities of the position at hand, is preferred.
• Experience in conducting compliance investigations, legal internal investigations, or similar investigations is required;
• Managerial experience in a healthcare organization or related setting is preferred.
Technical:
• Proficiency in Microsoft Word, Excel, PowerPoint.
Other Required Skills
• Demonstrated current knowledge of business ethics, legal and compliance risks.
• Advanced and highly developed communication and influencing skills.
• Excellent writing skills.
#LI-AW1
About Us
At Atlantic Health System, our promise to our communities is; Anyone who enters one of our facilities, will receive the highest quality care delivered at the right time, at the right place, and at the right cost. This commitment is also echoed in the respect, development and opportunities we give to our more than 20,000 team members. Headquartered in Morristown, New Jersey, we are one of the leading non-profit health care systems in the nation.
We also have more than 900 community-based healthcare providers affiliated through Atlantic Medical Group. Atlantic Accountable Care Organization is one of the largest ACOs in the nation, and we are a member of AllSpire Health Partners.
We have received awards and recognition for the services we have provided to our patients, team members and communities. Below are just a few of our accolades:
100 Best Companies to Work For and FORTUNE magazine for 15 years
Best Places to Work in Healthcare - Modern Healthcare
150 Top Places to work in Healthcare - Becker's Healthcare
100 Accountable Care Organizations to Know - Becker's Hospital Review
Best Employers for Workers over 50 - AARP
Gold-Level "Well Workplace": Wellness Council of America (WELCOA)
One of the 100 Best Workplaces for “Millennials” Great Place to Work and FORTUNE magazine
One of the 20 Best Workplaces in Health Care: Great Place to Work and FORTUNE magazine
Official Health Care Partner of the New York Jets
NJ Sustainable Business
Atlantic Health System offers a competitive and comprehensive Total Rewards package that supports the health, financial security, and well-being of all team members. Offerings vary based on role level (Team Member, Director, Executive). Below is a general summary, with role-specific enhancements highlighted:
Team Member Benefits
Medical, Dental, Vision, Prescription Coverage (22.5 hours per week or above for full-time and part-time team members)
Life & AD&D Insurance.
Short-Term and Long-Term Disability (with options to supplement)
403(b) Retirement Plan: Employer match, additional non-elective contribution
PTO & Paid Sick Leave
Tuition Assistance, Advancement & Academic Advising
Parental, Adoption, Surrogacy Leave
Backup and On-Site Childcare
Well-Being Rewards
Employee Assistance Program (EAP)
Fertility Benefits, Healthy Pregnancy Program
Flexible Spending & Commuter Accounts
Pet, Home & Auto, Identity Theft and Legal Insurance
____________________________________________
Note: In Compliance with the NJ Pay Transparency Act (effective Sunday, June 1, 2025), all job postings will include the hourly wage or salary (or a range), as well as this summary of benefits. Final compensation and benefit eligibility may vary by role and employment status and will be confirmed at the time of offer.
EEO STATEMENT
Atlantic Health System, Inc. is an equal employment opportunity employer and federal contractor or subcontractor and therefore abides by applicable laws to protect applicants and employees from discrimination in hiring, promotion, discharge, pay, fringe benefits, job training, classification, referral, and other aspects of employment, on the basis of race, color, religion, sex (including pregnancy, gender identity and sexual orientation), national origin, citizenship status, disability, age, genetics, or veteran status.
Job Identification22703
Job CategoryLegal/Comp/RiskMgmt/GovAffairs
Posting Date10/01/2025, 06:44 AM
Job ScheduleFull-Time
Locations 475 South Street, Morristown, NJ, 07960, US
Minimum Salary (Hourly Rate)58.560000
Maximum Salary (Hourly Rate)103.060000
Assignment CategoryFull-time
Hours per Week37.5
Primary ShiftDay
Work Schedule8 am - 4 pm
Days and ShiftsM-F 8am to 4pm
Department101000086001 - Legal Internal Audit - Corporate Compliance
DivisionCorporate
SpecialtyOther
Service LineOther
RegionCorporate
Salary Admin PlanPRO
Overtime StatusExempt
$77k-108k yearly est. 2d ago
Compliance and Privacy Officer
Alameda County Health 4.4
San Leandro, CA jobs
PLEASE READ THIS JOB ANNOUCEMENT IN ITS ENTIRETY. An Alameda County Job Application is required to be considered for ALL County recruitments.
Compliance and Privacy Officer
Alameda County Health, Behavioral Health Department is recruiting for its next:
Compliance and Privacy Officer
$140,088.00-$170,289.60 Annually
Placement within this range is dependent upon qualifications.
Plus, an excellent benefits package!
This is a provisional recruitment.
*For a provisional appointment, a civil service exam is not required. However, to obtain a regular position, the appointee will need to compete successfully in a County Exam when open.
This position requires CA residency.
Please do not hesitate to contact Tyler (*********************), if you have any questions regarding the position or recruitment process.
About Us
As part of Alameda County Health, the Behavioral Health Department supports people with Medi-Cal and without insurance living with serious mental illness and substance use conditions along their path toward wellness, recovery, and resiliency. We provide services through a network of contracted mental health and substance use providers and administer the State's resources and training for behavioral health providers, case managers, and other healthcare professionals. We advocate for our patients and families and create space for personal engagement in their care.
We are outpatient specialists for mental health services for older adults and youth, substance use providers and treatment program specialists, advocates for quality improvement and patients' rights, and psychiatric and integrated health care providers.
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The POSITION
Under general direction, the designated program Compliance and Privacy Officer (CPO) plans, organizes, directs, monitors, and promotes an effective compliance and privacy program. This position ensures that departmental compliance programs are consistent with Alameda County Health (ACH) Standards of Conduct and core values, policies and procedures, and promote adherence to applicable federal and state laws to advance the prevention of healthcare fraud, waste, and abuse, while providing quality care and services to those served by ACH; oversee all ongoing activities related to the development, implementation, maintenance, and adherence to ACH's policies and procedures covering the privacy of and access to protected health information (PHI) in compliance with applicable state and federal laws; and performs other related work as required.
DISTINGUISHING FEATURES
This classification is in ACH and reports to the Chief Compliance and Privacy Officer and is responsible for the broad coordination of the Department's comprehensive healthcare compliance and privacy assurance program. The incumbent is responsible for coordinating and performing activities related to education, training, auditing, and investigations to ensure employee awareness and compliance with the program and may serve as project manager overseeing the development, implementation, and maintenance of related programs. This classification is distinguished from the Quality Assurance Administrator classification which has primary responsibility for day-to-day operational issues focused on the appropriate and effective delivery of services to clients whereby this classification is focused on broader departmental-wide compliance activities.
EXAMPLE OF DUTIES
NOTE: The following are the duties performed by employees in this classification. However, employees may perform other related duties at an equivalent level. Each individual in the classification does not necessarily perform all duties listed.
Implements and oversees the compliance and privacy program at departmental level to ensure the program meets the state/federal requirements and is aligned with the Alameda County Health Office of Compliance Services (OCS)
Acts as a consultative resource for the entity leadership and associates on compliance and privacy matters. Provides overall leadership on issues concerning compliance and privacy, including developing and implementing controls designed to ensure compliance with applicable laws, rules and regulations, accurate coding and billing, contract agreements and detect and deter fraud, waste, and abuse.
Identifies compliance vulnerabilities and risks, ensures that responses to reported concerns, alleged violations of the law, and/or conflict of interest, privacy, are reported in a timely appropriate, and consistent.
Ensures the implementation and maintenance of an effective healthcare compliance and privacy program for the entity which will include conducting relevant risk assessments and developing risk-based compliance work plans.
Maximize current strengths of the healthcare compliance and privacy program, identify and remedy gaps, proactively assess and address emerging compliance risks.
.Leads and participates in Compliance Team Projects and initiatives when requested (e.g., exclusion monitoring, triennial audits, etc.)
Oversees the implementation of corrective actions and monitoring in response to identified issues, audits, and annual work plan items.
Independently investigates or supervises the investigation of compliance or privacy concerns raised through the Agency Helpline or other reporting mechanisms.
Ensures distribution, implementation, and education regarding compliance policies and procedures, fraud waste and abuse, conflict of interest, code of conduct, billing and documentation, HIPAA privacy, and security awareness training.
Participates in the development and implementation of annual work plan, enterprise risk assessment, and management and aligns entity risk assessment with the Agency risk management plans.
Chairs or co-chairs the entity compliance and privacy committees and reports to the entity and Agency level leadership on compliance matters and progress on a regularly established frequency.
Maintains knowledge of rules and regulations (healthcare compliance, HIPAA, HITECH, state privacy laws, etc.) that impact specific service areas and the organization and acts as a subject matter expert to support and provide guidance to workforce members.
Develops and maintains collaborative relationships with leaders and stakeholders across the organization.
Identifies opportunities and supports efforts to build a culture of compliance.
Performs other duties as assigned.
Compliance and Privacy Officer
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MINIMUM QUALIFICATIONS
EDUCATION:
Possession of a bachelor's degree in public health, health care administration, social work, business administration, public administration, nursing, or a related field.
AND
EXPERIENCE:
The equivalent of four (4) years of responsible, professional-level healthcare compliance and recent experience in one or more of the following areas in a healthcare delivery setting consisting of community health clinics, hospitals, skilled nursing facilities, physician practices, health insurance plans, or other healthcare settings with a focus on regulatory compliance, quality assurance, health care law and/or administration, risk management and/or regulatory investigations.
CERTIFICATE:
Possession of a Healthcare Compliance Certificate issued by the Healthcare Compliance Association's Certification Board.
HOW TO APPLY
Please email your County of Alameda Job Application, resume and cover letter to:
Tyler (*********************)
The application template is available online on Alameda County's Online Employment Center @
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NEW USERS can click on “Fill out an application” to fill out an application template. Once the application is completed, candidates can click on the “Review” tab to “Print My Application” or “SAVE as PDF”. AN ALAMEDA COUNTY JOB APPLICATION MUST BE SUBMITTED TO ********************* TO BE CONSIDERED FOR THE POSITION.
Alameda County HCSA is enriched with a diverse workforce. We believe the best way to deliver optimal programs and services to our communities is to hire and promote talents that are representative of the communities we serve. Diverse candidates are strongly encouraged to apply.
BENEFITS
In addition to a competitive salary, employees also enjoy an attractive benefits package with the following elements:
For your Health & Well-Being
Medical and Dental HMO & PPO Plans
Vision or Vision Reimbursement
Basic and Supplemental Life Insurance
Accidental Death and Dismemberment Insurance
Flexible Spending Accounts - Health FSA, Dependent Care and Adoption Assistance
Short and Long -Term Disability Insurance
Voluntary Benefits - Accident Insurance, Critical Illness and Legal Services
Employee Assistance Program
For your Financial Future
Retirement Plan - (Defined Benefit Pension Plan)
Deferred Compensation Plan (457 Plan or Roth Plan)
Annual Cost of Living Adjustments as determined by bargaining units
May be eligible for Public Service Loan Forgiveness
May be eligible for up to $3,300 in annual County allowance
For your Work/Life Balance
12 paid holidays
4 Floating holidays and 7 Management Paid Leave days
Vacation and sick leave accrual
Vacation purchase program
Catastrophic Sick Leave
Employee Mortgage Loan Program
Group Auto/Home Insurance
Pet Insurance
Commuter Benefits Program
Employee Wellness Program
Employee Discount Program
Child Care Resources
*Benefit rates are dependent upon the management employee's represented or unrepresented classification.
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$140.1k-170.3k yearly 5d ago
Nutrition Coordinator, Baptist Beaches
Baptist Health-Florida 4.8
Jacksonville Beach, FL jobs
* Offering $1,500 sign on bonus if hired*
Baptist Medical Center Beaches is currently hiring for a Full-time, Nutrition Coordinator to join our Patient Food Service team at our Baptist Beaches Location here in the Jacksonville, FL area. This is a full-time opportunity working 12 hour shifts 3.5 days a week with rotating weekends.
Nutrition Coordinators on the Baptist Food Service team are part of the caregiving team, responsible for patient safety and satisfaction goals by making sure meals are accurate and delivered at the right time and temperature. Nutrition Coordinators are assigned units in a healthcare facility, provide services that include helping patients make menu selections, assembly, delivery, and retrieval trays.
Nutrition Coordinator, Patient Food Service, Essential Duties and Responsibilities:
Assist patients in understanding their menu selections and work with nursing to ensure sure their orders comply with their nutritional requirements or restrictions. Obtain preferences and modifies tray identifiers accordingly.
Support and promote patient satisfaction and participate with a multidisciplinary team to improve quality care/services to patients.
Work with caregivers and culinary team to determine menu alternatives for patients with food allergies and sensitivities; cultural, ethnic, and religious preferences; or when a patient inquiry about additional selections.
Manage tray tickets and assemble meals according to each patient's menu selection in a timely and accurate manner. Deliver and Retrieve trays from patient rooms at assigned times.
Communicate problems or concerns with patients to appropriate personnel in a timely manner, following department procedures.
Performs other duties assigned.
If you are interested in this opportunity, please apply today!
Baptist Beaches provides beaches residents with easy access to comprehensive, high-tech medical and surgical care close to home. We offer the only hospital-based, 24-hour emergency service at the beach.
Full/Part Time
Full-Time
Shift Details
Various shifts
Education Required
None
Education Preferred
High School Diploma/GED
Experience
* Less than 1 year Customer Service Experience Required
Licenses and Certifications
None
Location Overview
Baptist Medical Center Beaches provides beaches residents with close-to-home access to comprehensive, high-tech medical and surgical care. Baptist Medical Center Beaches is a Magnet hospital in Jacksonville Beach, Florida, just minutes away from the Atlantic Ocean. As the only hospital located in the beach communities, Baptist Beaches provides a wide range of services for local residents. Besides being close to Jacksonville's beautiful beaches, fishing pier and multitude of golf courses, Baptist Beaches is a short drive away from TPC Sawgrass, home of The Player's Championship annual golf tournament. Baptist has been named one of the 100 Best Places to Work in Healthcare in the U.S. by Modern Healthcare. Baptist Beaches has been designated as a Primary Stroke Center by the Agency for Health Care Administration.
$47k-67k yearly est. 5d ago
Compliance Coordinator
Rural Health Care Inc. Dba Aza Health 4.1
Palatka, FL jobs
This is a full-time position, Monday through Thursday, 8:00 am - 6:30 pm. The ComplianceCoordinator is responsible for implementing and monitoring compliance, risk management, and quality improvement activities as directed by the Corporate Compliance Officer (CCO). Works with the CCO to ensure proper compliance with regulatory agencies, accrediting bodies, and Aza Health (AH) policies and procedures. Assists CCO with data collection, analysis, reporting and team facilitation; assists with the creation of graphs, forms, and reports on compliance, quality improvement and risk management activities; assists with the administrative functions of peer review; and, assesses the safety of the workplace environment based on legal requirements, including adherence to Occupational Health and Safety (OHS) guidelines, to reduce work-related injuries and trains employees to understand the rules and assists with the development and implementation of corrective action plans to resolve identified issues. This position reports directly to the Corporate Compliance Officer. This position serves as Vice Chair of AH's Continuous Quality Improvement (CQI) Committee and as Risk Manager, Safety/Infection Control Officer, HIPAA Privacy and Security Officer, and Claims Point of Contact in the absence of the CCO.
A non-profit, federally qualified health center headquartered in Palatka, FL, is seeking a motivated and experienced professional to assist with the development, implementation, data collection, monitoring, and evaluation of AH's compliance, quality improvement, and risk management plans/programs and activities. The company provides primary care services at multiple sites across a 6-county area and employs over 250 staff members.
CANDIDATES MUST POSSESS: A bachelor's degree in a health care-related field or FL LPN or RN license; a minimum of five years of experience in health care compliance, quality improvement/ quality assurance, and/or risk management; leadership and training experience preferred. Computer literacy and experience with electronic health records; familiarity with health care laws, accreditation regulations, and standards; superb written and oral communication skills; and excellent organizational skills. FQHC experience preferred but not required.
$44k-66k yearly est. Auto-Apply 45d ago
Hospice Quality & Compliance Coordinator
Trinity Hospice 3.8
San Antonio, TX jobs
To be considered, you must have at least 3 years of RN experience working for a hospice agency/program in a leadership capacity, or, background specifically as a hospice quality and compliance nurse as a corporate/home office employee.
Quality & ComplianceCoordinator
In short, you will help support the quality and compliance position of our business, directly reporting to the Chief Operations Officer. This role will travel on site approx. 25% of the time to our offices with the amount varying by the needs of the offices. This is a 75% remote role, meaning, you can live anywhere in the United States, with preference that you live in a state in which we have an office in (Texas, Oklahoma, Virginia, Missouri, Illinois, Colorado).
What You Will Do Every Day:
Complete ongoing, comprehensive, and integrated assessment of the quality and appropriateness of the care provided, including services provided under arrangement.
This person will do site visits as needed identifying trending factors, present those items of non-compliance to the COO and Director of Quality Assurance. Based on trending needs, an education plan will be conducted primarily by this role.
Create compliance and quality education materials and present on that material.
Monitor all service providers for effective interchange and coordination of care.
Management of Quality Specialists whom assist this role directly to gather data for process improvements, and education needs.
Conduct audits to ensure Quality and Compliance with real time feedback to the agency's leaders.
Ensure agency compliance with all local, state, and federal law relating to the operations of the agency.
Assist with establishment of a positive company culture, working to support leaders, and clinicians in their daily roles.
Background You Need to Be Successful:
Degree in Nursing or related field from an accredited college/university.
Current Registered Nurse (RN) license. (Compact State Preferred)
At least three years of experience in a hospice-specific quality or compliance role and/or Hospice Leadership required.
Knowledge and background in Hospice regulations. (State/ACHC)
Strong ability to develop strong working relationships with all levels of staff.
Background in managing an assistant/ support specialists daily to gather data for process improvements, and education needs.
Background in developing educational content relative to hospice specific quality and compliance measures.
$50k-60k yearly est. 2d ago
Compliance Coordinator
Legacy Home Health Agency 3.9
McAllen, TX jobs
Join Our Team at Legacy Home Health Agency!
At Legacy Home Health Agency, we are committed to delivering high-quality, compliant care to every client we serve. We're seeking a ComplianceCoordinator to help ensure that our operations, documentation, and services consistently meet internal standards and external regulations.
Key Responsibilities
Monitor and ensure compliance with Medicaid and other applicable federal and state regulations.
Conduct internal audits of documentation, charts, and billing to identify compliance risks or trends.
Track and follow up on corrective action plans and monitor resolution of compliance issues.
Assist in preparation for surveys, inspections, and audits by licensing or accrediting bodies.
Maintain accurate compliance logs, reports, and tracking systems.
Collaborate with supervisors, coordinators, and training staff to reinforce policies and regulatory updates.
Support ongoing training efforts on compliance-related topics.
Qualifications
Previous experience in healthcare compliance, auditing, quality assurance, or a related field preferred.
Knowledge of Medicaid guidelines and home care regulations a plus.
High attention to detail and strong organizational skills.
Ability to manage sensitive information and exercise sound professional judgment.
Proficient in Microsoft Office and EMR systems.
Bilingual
What We Offer
Opportunity to work in a mission-driven, client-centered environment
Supportive leadership and training programs
Competitive pay and benefits
Career growth opportunities within a growing agency
to help ensure that every aspect of our care meets the highest standards of integrity and quality!
$42k-59k yearly est. 44d ago
Compliance Coordinator
Legacy Home Health Agency 3.9
McAllen, TX jobs
Join Our Team at Legacy Home Health Agency!
At Legacy Home Health Agency, we are committed to delivering high-quality, compliant care to every client we serve. Were seeking a ComplianceCoordinator to help ensure that our operations, documentation, and services consistently meet internal standards and external regulations.
Key Responsibilities
Monitor and ensure compliance with Medicaid and other applicable federal and state regulations.
Conduct internal audits of documentation, charts, and billing to identify compliance risks or trends.
Track and follow up on corrective action plans and monitor resolution of compliance issues.
Assist in preparation for surveys, inspections, and audits by licensing or accrediting bodies.
Maintain accurate compliance logs, reports, and tracking systems.
Collaborate with supervisors, coordinators, and training staff to reinforce policies and regulatory updates.
Support ongoing training efforts on compliance-related topics.
Qualifications
Previous experience in healthcare compliance, auditing, quality assurance, or a related field preferred.
Knowledge of Medicaid guidelines and home care regulations a plus.
High attention to detail and strong organizational skills.
Ability to manage sensitive information and exercise sound professional judgment.
Proficient in Microsoft Office and EMR systems.
Bilingual
What We Offer
Opportunity to work in a mission-driven, client-centered environment
Supportive leadership and training programs
Competitive pay and benefits
Career growth opportunities within a growing agency
Apply now to help ensure that every aspect of our care meets the highest standards of integrity and quality!
$42k-59k yearly est. 29d ago
Intake Compliance Coordinator
Epic Health Partners 4.3
Richmond, VA jobs
EPIC Health Partners is seeking detail‑oriented, motivated, and a reliable Compliance Specialist. In this role, you will help ensure our programs meet all regulatory, and internal standards through accurate documentation review, data tracking, and collaboration with multidisciplinary teams. If you are looking for a meaningful career in behavioral health and enjoy work that supports high-quality care, we want to hear from you!
Key Responsibilities:
Conduct routine chart reviews and audits to ensure accuracy, completeness, and compliance with regulatory and organizational requirements.
Make all necessary corrections to documentation as required
Communicate when charts are complete and fully compliant
Follow up with staff regarding missing or incomplete documentation
Maintain tracking logs, spreadsheets, and documentation systems to support ongoing compliance monitoring.
Review and upload documentation into the Electronic Health Record (EHR) in an organized and timely manner.
Qualifications:
High School diploma or equivalent
Experience in compliance, quality assurance, auditing, or documentation review within behavioral health or community-based services preferred.
Strong communication, documentation, and analytical skills.
High attention to detail and ability to manage multiple tasks with accuracy.
Proficiency with Microsoft Office, including Excel.
Ability to build collaborative working relationships across departments.
Strong organizational skills and ability to support adherence to policies, procedures, and regulatory standards.
$31k-45k yearly est. 16d ago
Compliance Coordinator
CCMC 4.7
Tucson, AZ jobs
Job Description
Do you thrive in a service-oriented environment where you are part of a collaborative team? Do you want to have a career with a company that values its employees?
We're CCMC, a community management company specializing in master-planned communities. Our vision of inspiring a resident-centric focus is brought to life by our core values: Integrity, Respect, Service and Community.
About the Community:
Live life to the fullest in this southwest Master Planned Community featuring two dog parks, a basketball court, barbecue grills, scenic walking trails, and peaceful ramadas-everything you need for fun, relaxation, and connection.
The ComplianceCoordinator will be working in a team environment providing support to other departments and working closely with the Community Manager. They provide a valuable service to our homeowners while preserving and enhancing property standards.
What you'll accomplish:
Providing education, materials, information and assistance to new and existing homeowners
Performing compliance checks and documenting, photographing and recording violations
Issuing violations with specific reference to property maintenance and aesthetics
Tracking and coordinating the fine process
Reviewing architectural requests and making sure they are submitted correctly
Responding to resident phone calls and emails in a professional way
Submitting work orders to maintenance staff and vendors when necessary
Receiving and processing assessment payments
Processing weekly debit card transactions and deposits
Greeting residents, guests, and vendors upon entering the association office
What we're looking for:
Experience with HOA operations preferred
Professional and adaptable, demonstrate good time management and have demonstrated an ability to maintain the confidentiality of business matters
Self-motivated, dependable, organized, and efficient with excellent problem-solving skills
Computer skills that include a strong working knowledge of MS Office programs such as Outlook, Word and Excel
Able to communicate effectively orally and in writing, and have high attention to detail
Have an excellent telephone manner, with a commitment to the highest customer service possible
Must have a valid driver's license in the state of employment and a personal vehicle with current liability insurance - standard mileage reimbursement provided
Flexibility to work after hours on occasion to attend meetings
Must pass a pre-employment drug screen and background check
If driving is, or becomes, a requirement of the role, it is required, at all times, that you hold a valid state driver's license for the class of vehicle you are driving, maintain a clean motor vehicle report, and hold current automobile insurance at statutory limits. You must notify Human Resources immediately regarding any change to your motor vehicle standing. CCMC may periodically review motor vehicle reports to ensure compliance with these requirements.
The physical requirements can vary, but generally, they may include:
Mobility: Ability to walk the grounds long distances in various weather conditions.
Lifting and Carrying: Occasionally lifting and carrying supplies or equipment up to 25 pounds.
Extended Sitting or Standing: Capability to sit or stand for extended periods during meetings or events.
Manual Dexterity: Skills in using technology, including computers and mobile devices.
Driving: Ability to operate vehicle to perform certain job functions. (Please note: We will request and review an MVR at the time of hire and on a periodic basis thereafter to ensure that employees maintain a satisfactory driving status.)
We are committed to creating an inclusive and accessible work environment. If you require reasonable accommodations during the application process or in performing the job duties as described in the posting, please email
******************
so we can review next steps together.
What we offer:
Comprehensive benefits package including medical, dental, and vision
Wellness program
Flexible Spending Accounts
Company-matching 401k contributions
Paid time off for vacation, holidays, medical, and volunteering
Paid parental leave
Training and educational assistance
Support programs, including Employee Assistance Program and Calm Health
Optional benefits including short- and long-term disability, life insurance, and pet insurance
Most importantly, a caring team who is dedicated to your success!
$43k-56k yearly est. Easy Apply 9d ago
Regulatory & Compliance Coordinator
Progressivehealth Career 3.6
Evansville, IN jobs
- ProgressiveHealth Rehabilitation, Inc. - Evansville, IN
We are looking for a Regulatory & ComplianceCoordinator to join our ProgressiveHealth team! This role plays a vital part in supporting regulatory compliance and documentation quality across our therapy service lines. The Coordinator conducts onsite rounding, completes chart/documentation reviews, and assists with survey readiness efforts to support safe, consistent, and compliant operations throughout ProgressiveHealth's therapy clinics and service areas.
This is a full-time, Monday-Friday, dayshift, on-site position located at our Central Operations office on Evansville's west side.
This position requires confidentiality, strong organizational skills, attention to detail, and close collaboration with the Compliance Manager, clinical teams, and operational leadership.
What will you be doing in this role?
Conduct onsite regulatory rounding to ensure our therapy teams meet policy, payor, and survey standards; document findings and help drive timely corrective action.
Partner closely with the Compliance Manager to implement and maintain regulatory and compliance programs, participate in policy updates, and support ongoing education efforts.
Help keep the organization survey-ready by maintaining accurate logs, documentation, and processes; assist with mock surveys and help resolve any identified gaps.
Review charts and clinical documentation to confirm compliance with regulatory and payor requirements; identify risks and provide actionable feedback to support quality improvement.
Review and maintain patient intake forms and clinic documentation tools to ensure consistency and regulatory alignment across therapy service areas.
Maintain compliance trackers, monitor regulatory deadlines, and compile timely reports and metrics for leadership.
Contribute to the development and updating of compliance-related policies, procedures, and educational materials.
Support follow-up related to risk management incidents, patient concerns, and reported issues while maintaining strict confidentiality.
Assist with a variety of compliance tasks, projects, and administrative needs to support smooth daily operations.
Other duties as assigned.
This does not necessarily list all responsibilities, duties, requirements, or efforts associated with the job. While this list is intended to be an accurate reflection of the job, the company reserves the right to review and modify the functions, duties, and requirements of the job or to require that additional or different tasks be performed as circumstances or business needs require.
Our ideal candidate will have:
Minimum of three (3) years of experience in a healthcare, clinical, quality, or compliance-related role.
Experience with regulatory surveys (state, federal, accrediting bodies) and/or chart/documentation review preferred.
Previous experience in therapy services (physical, occupational, or speech therapy) or multi-site healthcare settings strongly preferred.
Strong communication skills with the ability to provide clear, constructive feedback to clinical staff.
Exceptional organizational skills, self-motivation, and the ability to prioritize in a fast-paced, deadline-driven environment.
Strong analytical skills with the ability to identify risk areas and recommend corrective actions.
Ability to work independently while also collaborating effectively across teams and locations.
A high degree of professionalism and commitment to confidentiality.
Proficiency with Microsoft Office and the ability to navigate multiple digital platforms.
Strong technology aptitude with experience using a variety of modern software platforms, including AI-enabled tools, and the ability to learn new systems quickly.
What you get from us:
Opportunity for important work/life balance with flexible scheduling!
Paid time off (PTO) & paid holidays
A robust benefits package: medical (HSA/FSA availability), dental, vision, and supplemental insurance options
Health improvement plan opportunities to lower premium costs
FREE use of the ProCare HealthSpot medical clinic for insured employees and dependents
Includes medical care, virtual visits with a 24/7 nurse call line, lab testing, and generic medications
Company-sponsored basic life/AD&D insurance and long-term disability insurance
401(k) & ROTH 401(k) savings plans + company match with auto-enrollment after probationary period
Continuing professional development
Opportunities for growth and advancement
Eligibility to Work:
This position requires candidates to be authorized to work in the United States on a full-time basis without requiring current or future sponsorship for an employment visa (e.g., H-1B, OPT, etc.).
About ProgressiveHealth:
ProgressiveHealth is the premier provider of a broad spectrum of occupational and non-occupational health services including on-site medical, injury prevention, health improvement, rehabilitation management solutions, and more! We are dedicated to delivering superior care and improving both patient and client outcomes. With over 1,000 employees supporting operations across the United States and in Canada, ProgressiveHealth continues to expand the number of client partners it serves and the lives it impacts.
An Equal Opportunity Employer
$39k-55k yearly est. 56d ago
Compliance Coordinator - Compliance
Healthright 360 4.5
San Francisco, CA jobs
.
HealthRIGHT 360 is a family of programs that provides compassionate care to people in need, by way of primary medical, mental health, and substance use disorder treatment and services. At HealthRIGHT 360, you'll work alongside like-minded colleagues who are passionate and committed to our work. Working at HealthRIGHT is a profound and meaningful experience and provides the opportunity to take part in supporting some of the most vulnerable communities in California and making a difference. Whether you work in our administrative departments or are a frontline clinician, each position has a profound impact on our mission as whole- to help folks get better, do better, and be better. HealthRIGHT 360 is committed to fostering a diverse and equitable workforce and workplace through inclusive hiring practices, trainings, and staff led committee work. Our goal is that HealthRIGHT 360 is a safe and empowering place for all employees.
The ComplianceCoordinator is the liaison between the Behavioral Health Program and the Compliance Department. The ComplianceCoordinator is an integral partner to the behavioral healthcare team, helping to support the team to meet regulatory state/county and agency requirements. The Administrative Operations team at HealthRIGHT 360 follows a mission driven culture that is shaped by values of accountability, clear and honest communication, professionalism, work ethic, innovation, humility, and community.
Key Responsibilities
Key Leadership responsibilities:
Responsible for practicing the Department culture, values, and principles.
Responsible for the integration of Behavioral Health Programs and Compliance department to ensure accuracy and efficiency.
Meets regularly with Program Leadership to ensure their program is informed of new Compliance Procedures and Initiatives.
Represents HealthRIGHT 360 by attending external meetings and trainings, when assigned.
Key Chart Documentation and Audit Support:
Provides support and guidance to programs regarding applicable agency requirements.
Completes Internal Chart Audits and provides ongoing feedback to the programs concerning Medi-Cal documentation requirements.
Completes Chart Compliance Reports and contributes to Compliance Department efforts to provide feedback.
Responsible for maintaining internal tracking reports and updating them on a regular basis.
Provides supports for internal and external program audits, and corrective action plans, when applicable.
Key Interdisciplinary Collaborations and Communications:
Collaborates with the Billing and Electronic Health Record teams, as needed.
Collaborates with the medical records team, as needed.
Collaborates with other agency teams, as needed.
Key Administrative and Other responsibilities:
Maintains compliance with agency policies, procedures, and standards.
Arranges work schedule in accordance with agency needs and expectations.
Attends internal meetings as assigned (which may result in traveling to various local Counties).
Attends external meetings as assigned; May be the lead agency representative at specific County meetings (and provides a summary/notes/materials from these meetings).
In conjunction with clinical supervisors/directors, provides trainings to staff on documentation requirements, incident reporting process, HIPAA/42 CFR part 2, agency/program policies and procedures, grievance processes, and medical records process.
Provides support to programs with agency policies and procedures.
Runs credentials reports and monitors personnel credentials in the agency's electronic health record system.
Informs programs of active client Medi-cal verification/reports.
Provides assistance with updating materials, as needed.
And, other duties as assigned.
Education and Knowledge, Skills and Abilities
Education and Experience Required:
Bachelor's Degree experience.
Familiarity with DMC regulatory requirements.
Desired:
Background in compliance or auditing.
Background Clearance Required:
Must not be on active parole or probation.
Knowledge Required:
Culturally competent and able to work with a diverse population.
Experience working successfully with issues of substance abuse, mental health, criminal background, and other potential barriers to economic self sufficiency.
Strong proficiency with Microsoft Office applications, specifically Microsoft Word, Outlook, Microsoft Excel, and internet applications.
Skills and Abilities Required:
Knowledge of Clinical documentation (treatment plans, progress notes etc.).
Ability to enter data into various electronic systems while maintaining the integrity and accuracy of the data.
Professionalism, punctuality, flexibility and reliability are imperative.
Excellent verbal, written, and interpersonal skills.
Integrity to handle sensitive information in a confidential manner.
Action oriented.
Strong problem-solving skills.
Excellent organization skills and ability to multitask and juggle multiple priorities.
Outstanding ability to follow-through with tasks.
Ability to work cooperatively and effectively as part of an interdisciplinary team and independently assume responsibility.
Strong initiative and enthusiasm and willingness to pitch in whenever needed.
Able to communicate well at all levels of the organization including working with organization leadership and high-level representatives of partner organizations.
Able to work within a frequently changing project scope while maintaining overall direction and structured priorities.
Knowledge of co-occurring disorders and trauma informed treatment.
We will consider for employment qualified applicants with arrest and conviction records.
In compliance with the California Department of Public Health's mandate, all employees must be able to provide proof of COVID-19 vaccination. Medical and religious exemptions are available.
Tag: IND100.
.
HealthRIGHT 360 is a family of programs that provides compassionate care to people in need, by way of primary medical, mental health, and substance use disorder treatment and services. At HealthRIGHT 360, you'll work alongside like-minded colleagues who are passionate and committed to our work. Working at HealthRIGHT is a profound and meaningful experience and provides the opportunity to take part in supporting some of the most vulnerable communities in California and making a difference. Whether you work in our administrative departments or are a frontline clinician, each position has a profound impact on our mission as whole- to help folks get better, do better, and be better. HealthRIGHT 360 is committed to fostering a diverse and equitable workforce and workplace through inclusive hiring practices, trainings, and staff led committee work. Our goal is that HealthRIGHT 360 is a safe and empowering place for all employees.
The ComplianceCoordinator is the liaison between the Behavioral Health Program and the Compliance Department. The ComplianceCoordinator is an integral partner to the behavioral healthcare team, helping to support the team to meet regulatory state/county and agency requirements. The Administrative Operations team at HealthRIGHT 360 follows a mission driven culture that is shaped by values of accountability, clear and honest communication, professionalism, work ethic, innovation, humility, and community.
Key Responsibilities
Key Leadership responsibilities:
Responsible for practicing the Department culture and values.
Responsible for the integration of Behavioral Health Programs and Compliance department to ensure accuracy and efficiency.
Meets regularly with Program Leadership to ensure their program is informed of new Compliance Procedures and Initiatives.
Represents HealthRIGHT 360 by attending external meetings and trainings, when assigned.
Key Chart Documentation and Audit Support:
Provides support and guidance to programs regarding applicable agency requirements.
Completes Internal Chart Audits and provides ongoing feedback to the programs concerning Medi-Cal documentation requirements.
Reviews, monitors, and provides feedback on Title 9 requirements for specialty mental health documentation and criteria.
Ensures documentation links to associated medication support services for mental health clients.
Completes Chart Compliance Reports and contributes to Compliance Department efforts to provide feedback.
Responsible for maintaining internal tracking reports and updating them on a regular basis.
Provides supports for internal and external program audits, and corrective action plans, when applicable.
Key Interdisciplinary Collaborations and Communications:
Collaborates with the Billing and Electronic Health Record teams, as needed.
Collaborates with the medical records team, as needed.
Collaborates with other agency teams, as needed.
Key Administrative and Other responsibilities:
Maintains compliance with agency policies, procedures, and standards.
Arranges work schedule in accordance with agency needs and expectations.
Attends internal meetings as assigned (which may result in traveling to various local Counties).
Attends external meetings as assigned; May be the lead agency representative at specific County meetings.
In conjunction with clinical supervisors/directors, provides trainings to staff on documentation requirements, incident reporting process, HIPAA/42 CFR part 2, agency/program policies and procedures, grievance processes, and medical records process.
Provides support to programs with agency policies and procedures.
Runs credentials reports and monitors personnel credentials in the agency's electronic health record system.
Provides assistance with updating materials, as needed.
And, other duties as assigned
Education and Knowledge, Skills and Abilities
Education and Experience Required:
Master's Degree, or, in place of a Master's Degree a Bachelor's Degree AND a minimum of three (3) years of Compliance and/or Clinical work experience.
Desired:
Familiarity with DMH (mental health) regulatory requirements.
Background in compliance or auditing.
Background Clearance Required:
Must not be on active parole or probation.
Knowledge Required:
Culturally competent and able to work with a diverse population.
Experience working successfully with issues of substance abuse, mental health, criminal background, and other potential barriers to economic self sufficiency.
Strong proficiency with Microsoft Office applications, specifically Microsoft Word, Outlook, Microsoft Excel, and internet applications.
Skills and Abilities Required:
Knowledge of Clinical documentation (treatment plans, progress notes etc.).
Ability to enter data into various electronic systems while maintaining the integrity and accuracy of the data.
Professionalism, punctuality, flexibility and reliability are imperative.
Excellent verbal, written, and interpersonal skills.
Integrity to handle sensitive information in a confidential manner.
Action oriented.
Strong problem-solving skills.
Excellent organization skills and ability to multitask and juggle multiple priorities.
Outstanding ability to follow-through with tasks.
Ability to work cooperatively and effectively as part of an interdisciplinary team and independently assume responsibility.
Strong initiative and enthusiasm and willingness to pitch in whenever needed.
Able to communicate well at all levels of the organization including working with organization leadership and high-level representatives of partner organizations.
Able to work within a frequently changing project scope while maintaining overall direction and structured priorities.
Knowledge of co-occurring disorders and trauma informed treatment.
In compliance with the California Department of Public Health's mandate, all employees must be able to provide proof of COVID-19 vaccination. Medical and religious exemptions are available.
Tag: IND100
$41k-54k yearly est. Auto-Apply 60d+ ago
Compliance Coordinator
Foundcare 3.8
West Palm Beach, FL jobs
Requirements
REQUIRED KNOWLEDGE, SKILLS AND ABILITIES:
Strong verbal and written communication skills, including the ability to communicate effectively in the English language, with or without the use of auxiliary aids or services.
Excellent organizational and analytical skills, with attention to detail.
Strong interpersonal skills.
Ability to interact and work with diverse populations.
Ability to maintain confidentiality and discretion.
Ability to manage multiple tasks with competing deadlines.
Ability to review, understand and apply concepts presented in training programs, conferences, and/or professional literature.
Proficiency in Microsoft Office Suite (Excel, Word, Outlook, PowerPoint).
Working knowledge of healthcare compliance standards (CMS, HRSA, HIPAA, OIG) preferred.
PHYSICAL REQUIREMENTS:
Ability to endure short, intermittent, and/or long periods of sitting and/or standing in the performance of job duties.
Accomplish job duties using various types of equipment/supplies, e.g. pens, pencils, calculators, computer keyboard, telephone, etc.
Ability to lift and carry objects weighing 25 pounds or less.
Ability to travel to other FoundCare locations and perform job duties.
Ability to travel to other locations to attend meetings, workshops, and seminars, plus travel to other FoundCare departments and FoundCare conference rooms.
MINIMUM QUALIFICATIONS:
High school diploma, or GED equivalent, required.
Associate or Bachelor's degree preferred.
Minimum of two (2) years of administrative or compliance experience in a healthcare setting preferred.
Familiarity with audit processes or regulatory reporting preferred.
Salary Description $40,000 - $50,000
$40k-50k yearly 4d ago
Compliance QI Coordinator
Open Skies Healthcare 3.4
Albuquerque, NM jobs
Job Description
Primary Job Responsibilities
Support compliance with all regulatory agencies as well as MCO. Client file audit Foster Parent File Audit Incident report tracking track Occurrence Reports
Responsible for facilitating and/or conducting internal audits as dictated by the Master Audit Schedule. Will assist in the development and implementation of Corrective Action Plans (CAP) resulting from an internal or external audit, to include training for required departments.
Will maintain and revise the Master Audit Schedule on an annual basis. Ensures compliance with all regulatory and credentialing standards and internal Policies and SOPs.
Oversee all areas of compliance measures. Investigate, review, and follow up on all investigations until adequate closure is met. Will analyze and review trends within each department and report trends for continuous quality improvement efforts.
Maintains all existing licensure or registrations for Open Skies Healthcare. Assists with new applications for licensure or registration (when applicable).
Performs other related duties as assigned.
$28k-33k yearly est. 27d ago
QUALITY & COMPLIANCE COORDINATOR - PACE
Chinatown Service Center 3.9
Alhambra, CA jobs
Job Purpose The Quality & ComplianceCoordinator supports the PACE organization's efforts to maintain high standards of quality, regulatory compliance, and organizational integrity. This role assists with quality improvement initiatives, compliance monitoring, data reporting, and audit readiness to ensure adherence to CMS, DHCS, and state/federal regulatory requirements. The Coordinator works closely with the Quality/Compliance leadership, interdisciplinary team (IDT), and operational departments to promote participant safety, service excellence, and continuous improvement.
Duties and Responsibilities
Quality Improvement (QI)
* Assist in planning, implementing, and evaluating the organization's Quality Improvement Program.
* Collect, track, and analyze quality metrics, participant data, and performance indicators.
* Support QAPI projects, root cause analyses (RCA), and performance improvement plans.
* Maintain QI dashboards, logs, and documentation for internal use and external reporting.
* Coordinate and monitor corrective action plans (CAPs) and follow-up activities.
Compliance & Regulatory Support
* Support ongoing compliance monitoring to ensure adherence to CMS, DHCS, and state regulatory requirements for PACE programs.
* Assist with policy and procedure development, review, and revision.
* Track compliance deadlines, training requirements, audits, and reporting obligations.
* Conduct routine compliance audits, including personnel file reviews, encounter data monitoring, documentation review, and service tracking.
* Support oversight of vendor compliance and credentialing as assigned.
Audit Preparation & Monitoring
* Assist with preparation for internal and external audits (CMS, DHCS, HHS, internal compliance reviews).
* Maintain organized audit files, evidence documentation, and submission materials.
* Track audit findings and corrective actions to ensure timely resolution.
Incident Reporting & Risk Management
* Assist in intake, logging, tracking, and follow-up of reportable incidents, grievances, and participant complaints.
* Participate in investigations by gathering documentation and supporting the Quality/Compliance team.
* Prepare monthly and quarterly reports for committees and leadership.
Education & Training
* Assist in scheduling, documenting, and tracking mandatory trainings such as HIPAA, compliance, safety, and PACE-specific regulatory requirements.
* Participate in onboarding education related to compliance and quality expectations.
Committee & Administrative Support
* Provide administrative support for Quality Assurance/Performance Improvement (QAPI), Compliance, and Safety Committee meetings.
* Prepare agendas, take minutes, and track follow-up actions.
* Other duties as assigned.
Qualifications
Education & Experiences:
* Associate's or Bachelor's degree in Health Administration, Nursing, Public Health, Business Administration, or related field preferred.
* Minimum 2 years of experience in healthcare quality, compliance, managed care, or related field.
* Experience with PACE, long-term care, or regulatory programs (CMS/DHCS) strongly preferred.
Knowledge, Skills & Abilities
* Understanding of CMS and DHCS regulations governing PACE programs.
* Strong analytical and organizational skills with high attention to detail.
* Ability to interpret regulatory guidelines and apply them operationally.
* Excellent written and verbal communication skills.
* Proficiency in data tracking systems, Microsoft Office, and electronic health records (EHR).
* Ability to maintain confidentiality and adhere to HIPAA requirements.
* Ability to work collaboratively with cross-functional teams.
Other:
* Requires physical strength to perform the job.
* Routine travel between PACE sites and in the community required.
* Requires valid driver's license.
Physical Demands
* Must be able to remain in a stationary position 50% of the time.
* Ability to occasionally move about inside the office to access file cabinets, office machinery, etc.
* Able to operate a computer and other office productivity machinery, such as a calculator, copy machine, and computer printer.
* Able to constantly position yourself to maintain files in file cabinets such as reaching with hands and arms, kneeling, crouching, etc.
* The ability to communicate, detect, converse with, discern, convey, express oneself, and exchange information is crucial for this role.
$45k-61k yearly est. 41d ago
Quality and Compliance Specialist (Full-Time/Towson)
Sheppard Pratt Careers 4.7
Towson, MD jobs
Under general supervision, conducts compliance audits and oversight activities within Sheppard Pratt.
Provides independent and objective review, evaluation and investigation of compliance and privacy issues/concerns, as assigned.
Audits to assure compliance with federal and state regulations, accreditation and quality standards, and SP policies.
Provides education to all personnel including physicians and clinicians regarding the ethics and compliance program.
Documents audit processes and findings and prepares appropriate reports for review by Sheppard Pratt leadership and Corporate Compliance Committee.
What we need from you
Knowledge of auditing standards, medical terminology and psychiatric disorders, behavioral health coding and documentation standards. Certified Professional Coder (CPC) or Certification in Healthcare Compliance (CHC) is preferred.
Bachelor's degree in psychology, public health, sociology, business administration; or equivalent experience.
If position is filled by any licensed discipline, requires possession of a current license in the State of Maryland at the time of appointment and continuously while in the position.
1-2 years of behavioral health experience and demonstrated knowledge of:
medical records documentation and process;
knowledge of state and federal healthcare privacy laws;
Medicare and Medicaid program rules and regulations and experience applying to CPT coding and billing of hospital services;
PC literacy with intermediate proficiency in Microsoft Office Suite, Including Excel, Access, PowerPoint, Word, data analysis tools and techniques.
Proficiency in using electronic health record systems (EHRs), incident management systems, policy management systems, and coding software.
Prior experience with CPT billing codes is preferred; individual must demonstrate willingness and ability to learn use of CPT coding.
What you'll get from us
At Sheppard Pratt, you will work alongside a multi-disciplined team led by a bold vision to change lives. We offer:
A commitment to professional development, including a comprehensive tuition reimbursement program to support ongoing education and licensure and/or certification preparation
Comprehensive medical, dental and vision benefits for benefit eligible positions
403b retirement match
Generous paid-time-off for benefit eligible positions
Complimentary Employee Assistance Program (EAP)
Generous mileage reimbursement program
The pay range for this position is $52,499.20 minimum to $81,078.40 maximum. Pay for this position is determined on a number of factors, including but not limited to, years and level of related experience.
WHY SHEPPARD PRATT?
At Sheppard Pratt, we are more than just a workplace. We are a community of healthcare professionals who are dedicated to providing hope and healing to individuals facing life's challenges. Join us and be a part of a mission that changes lives!
#LI-EEDWARDS
$52.5k-81.1k yearly 43d ago
Integrity and Compliance Consultant
Healthpartners 4.2
Bloomington, MN jobs
HealthPartners is hiring an Integrity and Compliance Consultant. Integrity and Compliance Consultants provide compliance support, partnership, and guidance to HealthPartners leaders and colleagues across the organization and business lines. Consultants may directly support one or more of the three Integrity and Compliance Program Services Groups: Oversight and Evaluation, Standards and Education, and Investigation and Resolution. Consultants are program builders and ambassadors; they know the rules and risks, and educate others about them. They help others make risk-based decisions, communicate clearly, and build and maintain strong partnerships.
ACCOUNTABILITIES:
Develops, maintains, and promotes HealthPartners Integrity and Compliance program expertise [Be a program builder and ambassador]
Lead and manage complex projects and initiatives that fall within the assigned program services group
Provide direction and guidance to analysts, as needed, and support their professional growth
Lead and support program services group when manager or other leader is unavailable (lead meetings, etc.)
Promote and execute collaboration within and across program services groups
Be an ambassador for the Integrity and Compliance Program
Help establish, know and meet required deadlines
Serve as subject matter expert on compliance issues [Know the rules and the risks, and educate others about them]
Serve as subject matter expert on program services group
Serve as primary point of contact for key business partners
Participate in industry groups, as identified
Use legal counsel, internal content experts, internal and external resources and trends relating to Compliance activities in developing and maintaining subject matter expertise
Conduct regulatory, policy, and other research on compliance matters using internal and external resources
Demonstrate understanding of and ability to articulate seven elements of an effective compliance program
Develop deep expertise of the work of assigned program services group
Support operational areas' compliance with applicable laws, regulations and requirements
Identify opportunities and risks; propose, facilitate/support, and implement solutions [Help others make risk-based decisions]
Proactively build organizational knowledge of the entire HealthPartners system.
Analyze business challenges that have compliance implications and propose solutions to identified risks and opportunities to department leaders and business partners.
Identify challenges, barriers and options for assigned projects/initiatives; work with business partners and department leaders to resolve
Identify, develop, and execute on opportunities for process improvement, innovation and automation within program services group
Communicate effectively [Be clear about it]
Support and present at Compliance Oversight Committees as needed
Write SBARs, reports and memoranda to document compliance and business challenges and proposed solutions
Communicate issues requiring escalation to managers and other leaders with appropriate level of detail
Build and maintain stakeholder partnerships [Build and maintain strong partnerships]
Be advisor/consultant to business areas and business leaders on compliance-related matters
Develop relationships with key internal stakeholders
Support business leaders on compliance matters
Meet regularly with leaders to understand compliance challenges and issues
Interact professionally with regulators and other outside officials
Assist with professional growth of analysts. Provide direction to analysts; provide support to manager with regular communication
REQUIRED QUALIFICATIONS:
Bachelor's degree; or equivalent work experience
4-6 years of experience in a healthcare or other highly regulated environment
Familiarity with reading, analyzing and working with healthcare or other complex laws, regulations and requirements
Familiarity with Microsoft Office applications, including Power Point, Excel and Visio
Ability to effectively communicate, both written and oral, with different audiences, and tailor messages accordingly
Ability to grasp new and complex concepts quickly, identify key impacts and translate for others
Ability to self-motivate, take initiative and engage in critical thinking
A drive for proactive and continuous improvement
System thinking/orientation
Experience supporting complex projects
Excellent organizational and time-management skills
Strong skills in research and information analysis
Strong commitment to accuracy and attention to detail
Ability to work in a fast-paced environment, adapt to changing conditions, and meet deadlines
Ability to work across departments with a collaborative, responsive, respectful approach
PREFERRED QUALIFICATIONS:
Advanced degree in relevant discipline such as JD, MHA, MPH or MBA
5 years of experience in a health care compliance role
Understanding of billing and reimbursement processes and systems; health financing; health insurance and/or data privacy in the health care environment.
$62k-81k yearly est. Auto-Apply 60d ago
Integrity and Compliance Consultant
Healthpartners 4.2
Bloomington, MN jobs
HealthPartners is hiring an Integrity and Compliance Consultant. Integrity and Compliance Consultants provide compliance support, partnership, and guidance to HealthPartners leaders and colleagues across the organization and business lines. Consultants may directly support one or more of the three Integrity and Compliance Program Services Groups: Oversight and Evaluation, Standards and Education, and Investigation and Resolution. Consultants are program builders and ambassadors; they know the rules and risks, and educate others about them. They help others make risk-based decisions, communicate clearly, and build and maintain strong partnerships.
ACCOUNTABILITIES:
Develops, maintains, and promotes HealthPartners Integrity and Compliance program expertise [Be a program builder and ambassador]
Lead and manage complex projects and initiatives that fall within the assigned program services group
Provide direction and guidance to analysts, as needed, and support their professional growth
Lead and support program services group when manager or other leader is unavailable (lead meetings, etc.)
Promote and execute collaboration within and across program services groups
Be an ambassador for the Integrity and Compliance Program
Help establish, know and meet required deadlines
Serve as subject matter expert on compliance issues [Know the rules and the risks, and educate others about them]
Serve as subject matter expert on program services group
Serve as primary point of contact for key business partners
Participate in industry groups, as identified
Use legal counsel, internal content experts, internal and external resources and trends relating to Compliance activities in developing and maintaining subject matter expertise
Conduct regulatory, policy, and other research on compliance matters using internal and external resources
Demonstrate understanding of and ability to articulate seven elements of an effective compliance program
Develop deep expertise of the work of assigned program services group
Support operational areas' compliance with applicable laws, regulations and requirements
Identify opportunities and risks; propose, facilitate/support, and implement solutions [Help others make risk-based decisions]
Proactively build organizational knowledge of the entire HealthPartners system.
Analyze business challenges that have compliance implications and propose solutions to identified risks and opportunities to department leaders and business partners.
Identify challenges, barriers and options for assigned projects/initiatives; work with business partners and department leaders to resolve
Identify, develop, and execute on opportunities for process improvement, innovation and automation within program services group
Communicate effectively [Be clear about it]
Support and present at Compliance Oversight Committees as needed
Write SBARs, reports and memoranda to document compliance and business challenges and proposed solutions
Communicate issues requiring escalation to managers and other leaders with appropriate level of detail
Build and maintain stakeholder partnerships [Build and maintain strong partnerships]
Be advisor/consultant to business areas and business leaders on compliance-related matters
Develop relationships with key internal stakeholders
Support business leaders on compliance matters
Meet regularly with leaders to understand compliance challenges and issues
Interact professionally with regulators and other outside officials
Assist with professional growth of analysts. Provide direction to analysts; provide support to manager with regular communication
REQUIRED QUALIFICATIONS:
Bachelor's degree; or equivalent work experience
4-6 years of experience in a healthcare or other highly regulated environment
Familiarity with reading, analyzing and working with healthcare or other complex laws, regulations and requirements
Familiarity with Microsoft Office applications, including Power Point, Excel and Visio
Ability to effectively communicate, both written and oral, with different audiences, and tailor messages accordingly
Ability to grasp new and complex concepts quickly, identify key impacts and translate for others
Ability to self-motivate, take initiative and engage in critical thinking
A drive for proactive and continuous improvement
System thinking/orientation
Experience supporting complex projects
Excellent organizational and time-management skills
Strong skills in research and information analysis
Strong commitment to accuracy and attention to detail
Ability to work in a fast-paced environment, adapt to changing conditions, and meet deadlines
Ability to work across departments with a collaborative, responsive, respectful approach
PREFERRED QUALIFICATIONS:
Advanced degree in relevant discipline such as JD, MHA, MPH or MBA
5 years of experience in a health care compliance role
Understanding of billing and reimbursement processes and systems; health financing; health insurance and/or data privacy in the health care environment.
$62k-81k yearly est. Auto-Apply 60d ago
Customs Compliance Specialist
Freudenberg Medical 4.3
Houston, TX jobs
Working at Freudenberg: We will wow your world!
Responsibilities:
Oversee daily import/export operations, ensuring compliance with U.S. and international customs regulations; maintain HTS codes in SAP and coordinate updates with the Regional Customs Lead.
Prepare and review customs entries, verify import values, apply for duty refunds, and resolve customs-related issues such as delays, inspections, and audits.
Collect and manage required documentation from suppliers, purchasing, and internal stakeholders to support customs clearance.
Coordinate with customs brokers, freight forwarders, and regulatory authorities to ensure smooth shipment clearance and timely deliveries.
Prepare Certificates of Origin (e.g., USMCA) and ensure correct application to optimize duty savings and compliance.
Support logistics operations, including shipment scheduling, material flow, inventory oversight, and accurate tracking of customs transactions.
Maintain complete and auditable records, provide documentation during audits, and prepare regular reports on import/export performance, compliance status, and cost metrics.
Report significant customs issues to the Regional Customs Lead, update local management on performance, and collaborate with Finance on customs-related invoices and reconciliations.
Qualifications:
Bachelor's degree in Supply Chain, Logistics, International Business, or related field (or equivalent experience).
Knowledge of U.S. and international customs regulations, import/export compliance, and tariff classifications (HTS codes).
Familiarity with ERP systems (SAP preferred) for customs, logistics, or inventory management.
Understanding of Certificates of Origin, trade agreements (e.g., USMCA), and duty optimization strategies.
Knowledge of freight forwarding, brokerage operations, and compliance reporting/auditing requirements.
Strong analytical thinking, attention to detail, and communication skills to identify compliance issues, ensure accuracy, and coordinate with stakeholders.
Primarily office-based role with occasional visits to warehouse or shipping/receiving areas; must be able to lift/carry up to 25 lbs.
Occasional travel required to coordinate with suppliers, customs brokers, or other facilities.
The Freudenberg Group is an equal opportunity employer that is committed to diversity and inclusion. Employment opportunities are available to all applicants and associates without regard to race, color, religion, creed, gender (including pregnancy, childbirth, breastfeeding, or related medical conditions), gender identity or expression, national origin, ancestry, age, mental or physical disability, genetic information, marital status, familial status, sexual orientation, protected military or veteran status, or any other characteristic protected by applicable law.
EagleBurgmann Industries LP