Inbloom Autism Services

Compensation

Full Description

Overview The role of the Compliance Director is to lead, strategize, and ensure the appropriate execution of all clinical compliance-related needs and expectations of the organization. The Compliance Director will be responsible for training, mentoring, and managing other team members who participate in compliance-related work, as well as clinicians and non-clinicians. The Compliance Director will oversee the preparation, completion, and submissions of internal and external compliance audits, monitor and ensure remediation of audit feedback, spearhead compliance initiatives, manage change within the organization to continually improve adherence to process and policy with relation to maintenance of medical records, maintenance of privacy and confidentiality (HIPAA), ethical conduct, aherence to clinical policy (e.g. billing practices, medical records storage, etc.). The Compliance Director will engage in ongoing collaboration directly with all layers of the leadership teams (clinical and non-clinical, regional and local), as well as HR, to develop process and procedure for best practice, to determine course of action when compliance issues arise, and to determine future needs and areas of opportunity within the organization. *Position may be REMOTE based however candidates must reside in any of the following states: Arizona, Colorado, Connecticut, Florida, Massachusetts, North Carolina, Tennessee, Texas and/or Wisconsin. **BCBA Certification required for this role Responsibilities To perform this job successfully, an individual must be able to perform each essential duty satisfactorily, as well as lead others who do the same. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. • Understands, abides by, and stays abreast of the Behavior Analyst Certification Board (BACB) guidelines as well as widely accepted industry ethical standards and billing practices. • Serves as primary point of contact between the Compliance Department and clinicians and non-clinicians on matters relating to clinical integrity, ethical standards, and compliancerelated process and procedure. Communicates compliance standards. • Collaborates with senior clinical leadership, HR, and billing team to ensure policies meet accepted industry ethical standards and best practices. • Provides consultation, as needed, regarding ethical dilemmas and considerations pertaining to clients and team members. • Leads compliance-related investigations alongside HR as applicable. • Stays abreast of payor policies and medical necessity requirements. Communicates changes / updates to appropriate leadership, and collaborates on any resolutions needed. • Reviews results of external audits ensuring compliance with payor policies and guidelines and disseminates payor feedback to leadership. • Participates in and coordinates the preparation of relevant policies, procedures, and documentation for accreditation and external audit needs, as applicable, and pending business need. • Oversees ongoing quarterly internal audit process and ensure remediation as applicable. • Completes ad hoc reviews of RBT and BCBA clinical standards and makes recommendations for improvement. • Collaborates with leadership to make ongoing recommendations on quality improvement measures. • Collaborates with HR regarding compliance-related InBloom policies and procedures. • Assists with and participates in the independent review and evaluation of the organization to ensure compliance with internal and external policies and procedures. • Serves as HIPAA / Privacy oversight and control. • Serves as medical records oversight and control. • Develops systems for tracking compliance related trends, ensures maintenance of tracking, and regularly evaluates data tracked in order to guide remediation / corrective actions / process improvements. • Performs other related duties as assigned Qualifications Education and Experience • BACB Board Certified Behavior Analyst (BCBA) required. • A Master’s degree in special education, psychology, or related field, with specialized knowledge of behavioral health and treatment philosophies and professional practices. • Displays extensive knowledge and training in behavior analysis. • Displays extensive knowledge of BACB code of ethics and industry ethical standards. • A minimum of one year working with children with autism spectrum disorders. • A demonstrated understanding of medical documentation requirements. • Strong project management skills and attention to detail Supervisory Responsibilities: oversees and manages team members within Compliance Department (e.g. Compliance Specialist) and may support and/or manage compliance-related activities within other departments (e.g. billing, credentialing, medical records). Work environment • Noise Level is moderate to loud Physical demands • Prolonged periods of sitting at a desk and working on a computer. • Must be able to lift 15 pounds at times. Travel required • None. Affirmative Action/EEO statement InBloom Autism Services provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.