Compliance Manager - Healthcare jobs in Alaska
Compliance Manager - Healthcare implements and administers programs, policies, and practices to ensure that organization complies with JCAHO, HIPAA, and accreditation standards. Monitors and administers compliance with federal, state, and local regulations. Being a Compliance Manager - Healthcare acts as a liaison to government agencies and coordinates site visits for regulators. Investigates potential compliance violations and takes corrective action as necessary. Additionally, Compliance Manager - Healthcare requires a bachelor's degree. Typically reports to a head of a unit/department. The Compliance Manager - Healthcare manages subordinate staff in the day-to-day performance of their jobs. True first level manager. Ensures that project/department milestones/goals are met and adhering to approved budgets. Has full authority for personnel actions. Extensive knowledge of department processes. To be a Compliance Manager - Healthcare typically requires 5 years experience in the related area as an individual contributor. 1 to 3 years supervisory experience may be required. (Copyright 2024 Salary.com)
Recently Added Compliance Manager - Healthcare jobs
- Cook Inlet Tribal Council Inc
-
Anchorage, AK
FULL_TIME
-
COOK INLET TRIBAL COUNCIL, INC.
JOB DESCRIPTION
Job Title: Compliance and Quality Assurance Manager
Department: 477 Employment and Training Services Department (ETSD)
Reports To: Senior Manager
Supervises: Compliance Officers, ISDA Compliance & Training Coordinator, Administrative Assistant
FLSA Status: Exempt
Pay Grade: E5
Job Type: Full-Time, Regular
AKBCU: Yes ICPA: Yes
General Functions:
The Compliance and Quality Assurance Manager is responsible for the oversight of program compliance throughout the Employment and Training Services Department (ETSD). This includes providing and coordinating staff training across the department on program requirements, eligibility and how to identify program fraud. The Compliance and Quality Assurance Manager manages the Quality Assurance Team, including Compliance Officers, the ISDA Compliance & Training Coordinator and an Administrative Assistant. The Quality Assurance Manager will conduct compliance reviews (investigations) on all ETSD financial assistance programs. This includes overseeing investigations, completing home visits, and compiling written reports of findings. Additionally, this position is responsible for program file reviews to ensure compliance with program policies, regulations, and statues. The Manager works with program staff to collect and document evidence concerning fraudulent activity and when necessary will meet with participants to discuss, present and complete Intentional Program Disqualifications and discuss service options moving forward.
Duties and Responsibilities including but not limited to:
- Perform home visits with participants to gather additional information about surrounding circumstances, and assess or evaluate situations regarding regulatory requirements, all to ensure participants are receiving all eligible services and provide documentation regarding service eligibility.
- Manage the Quality Assurance team, including compliance officers, ISDA Compliance & Training Coordinator and an Administrative Assistant.
- Provide department wide support through training and systems improvement as necessary, working in coordination with the management team to coordinate and train program staff on consistency and identifying fraud referrals.
- Responsible for preparing disposition reports regarding fraud referrals to staff and recommend case action.
- Responsible for preparing and completion of Intentional Program Violation Disqualification files, Administrative Disqualification Hearing files or cases for criminal prosecution.
- Provide all information and background on a participant case as requested by the Participants Rights Privacy Officer when a grievance is filed by a participant.
- Become familiar with the PL 102-477 Grant, ETSD financial assistance programs and program applications.
- Become familiar with the operation of the State of Alaska EIS and CITC 477 database and required state and federal reporting.
- Become familiar with the ETSD financial assistance programs, regulations and manuals, including those under other agencies such as child support services, permanent fund dividend program, department of labor, and housing programs.
- Conduct file reviews for ETSD programs for compliance and quality assurance.
- Manage recoupment collections process to ensure accuracy of payments and tracking.
- Maintain confidentiality according to regulations, policies, and procedures.
- Perform all other related duties as needed and assigned.
Job Specifications:
- Knowledge of P.L. 102-477 and all 477 ETSD programs and sub-program rules and regulations, requirements, policies and procedures and the ability to apply that knowledge to the most difficult caseload situations.
- Thorough knowledge of the EIS Operation, application and limitations plus the interagency interfaces.
- Demonstrated knowledge of interviewing and investigative techniques.
- Working knowledge of available community resources and services and possible application to an individual’s situation.
- Demonstrated ability to work independently with minimal supervision.
- Demonstrated proficiency in Microsoft office, including Word, Excel and Outlook.
- Demonstrated ability to organize work and time; establish priorities; work under pressure and meet deadlines.
- Demonstrated understanding of traditional Alaska Native and American Indigenous cultures and values, including an understanding of CITC’s Values.
- Demonstrated ability to write reports, business correspondence, and procedure manuals.
- Demonstrated ability to maintain composure and use diplomacy and tact when dealing with program participants.
- Demonstrated ability to interpret and apply program rules, regulations, policies and procedures, while making initial and continuing eligibility determinations, within strict time frames.
- Demonstrated ability to analyze and accurately classify types of employment, income resources, expenses and other variables surrounding a household composition.
- Demonstrated ability to effectively communicate program information and requirements to a wide variety of individuals, agency representatives, etc., and to establish and maintain cooperative working relationships.
- Demonstrated ability to mediate disputes and respond to applicant/recipient complaints.
Minimum Core Competencies: CITC Values, Respectful Leadership, Professionalism, Emotional Intelligence, Problem Solving/Critical Thinking, Communication Skills.
Minimum Qualifications:
- Demonstrated ability to work independently with minimal supervision.
- Bachelor’s degree in Business Management, Accounting or related field. May substitute for education requirement on a year-for-year basis.
- One (1) year of conducting fact finding investigations.
- Two (2) years supervision experience.
- Five (5) years’ experience involving: extensive person-to-person contact, explaining complex policies, procedures, services or requirements; eliciting or exchanging information as related to requirements or procedures; providing formal or informal instruction or training to people; or interviewing/counseling; or, two years of experience applying statutes, regulations, program requirements or similar criteria or guidelines to review of individual case. Related college work, from an accredited institution, may substitute for required experience on a case-by-case basis.
- Valid Alaska Driver's License and be insurable under CITC's automotive insurance, which requires a driver to be at least 21 years of age and have had a driver's license for at least three years.
- Continued employment is contingent upon receipt of satisfactory report from a state and federal background check.
Preferred Qualifications:
- Bachelors’ degree in Business Management, Accounting or related field.
- Knowledge of state statutes and code applicable to Department of Public Assistance, Department of Labor, Department of Revenue, knowledge of collections including Fair Debt Collections practices.
- Experience with fraud investigations in State EIS system.
Physical Requirements:
- Primarily works in an office setting, with extended periods of time at a desk and on a computer.
NATIVE PREFERENCE STATEMENT: Pursuant to the Indian Self-Determination and Education Assistance Act of 1975 (PL 93-638) and as further guided by CITC’s Native Preference Policy 6.120, CITC maintains preference in all phases of employment for Alaska Native, American Indian (AN/AI) and Native Hawaiian people, including direct lineal descendants and foster or traditionally adopted children. Also included are non-Native head of household members for Native families, which includes foster or traditionally adopted Native children.
Disclaimer
The information provided in this description has been designed to indicate the general nature and level of work performed by incumbents within this job. It is not designed to be interpreted as a comprehensive inventory of all duties, responsibilities, qualifications and working conditions required of employees assigned to this job. Management has sole discretion to add or modify duties of the job and to designate other functions as essential at any time. This job description is not an employment agreement or contract.
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