Job Information
Detroit Wayne Integrated Health Network Compliance Administrator in Detroit, Michigan
COMPLIANCE ADMINISTRATOR
Under the general supervision of the Vice President of Compliance, the Compliance Administrator assists the Vice President of Compliance in ensuring that the Board, management, and employees of DWIHN are following the rules and regulations of regulatory agencies, that DWIHN policies and procedures are being followed, and that behavior in the organization meets the Network's Standards of Conduct.
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PRINCIPAL DUTIES AND RESPONSIBILITIES:
- Serves as the primary assistant to the Vice President of Compliance for the administration of the DWIHN Compliance Office.
- Supervises various aspects of the compliance program.
- Serves as a leader and manages a team of professional investigators and maintains a team-oriented management style.
- Ensures proper adherence to policies and procedures.
- Responds to and manages individual compliance cases ensuring departmental compliance with all applicable laws and regulations during departmental actions.
- Manages and coordinates Compliance Investigations.
- Trains employees in proper case documentation.
- Tracks the caseload of the department, including reviewing new cases, tracking case progressions, and ensuring proper case resolution.
- Partners with colleagues to assist in the development and maintenance of new procedures and operational changes that minimize risk, add value, and anticipate trends in areas of responsibility.
- Develops and maintains procedures and operational changes that increase productivity, add value, and anticipate trends in areas of responsibility.
- Maintains meticulous records, including policies, procedures, and compliance documentation, to satisfy client and regulatory agency requirements.
- Provides oversight of the Certified Community Behavioral Health Clinics (CCBHC) for compliance with SAMSA regulations.
- Provides indirect oversight of the Community Mental Health Service Providers (CMHSPs).
- Completes Office of Inspector General (OIG) Reports.
- Conducts Compliance Staff Training for DWIHN employees.
- Reviews the DWIHN employee and provider credentialing process for compliance with regulatory standards.
- Consults with legal counsel as needed to resolve difficult legal compliance issues.
- Identifies potential areas of compliance vulnerability and risk.
- Develops and implements corrective action plans for resolution of problematic issues and provides general guidance on how to avoid or deal with similar situations in the future.
- Provides compliance and other related reports.
- Researches and analyzes available sources of regulatory guidance in response to specific questions.
- Monitors available sources of regulatory guidance to proactively address the necessary changes to the HIPAA compliance implementation plan based on documentation and feedback.
- Maintains a strong working knowledge of applicable regulatory guidelines.
- Coordinates with the appropriate administrative and support departments to adequately design implementation plans, policies and analyzes the effects of any proposed process changes required by HIPAA.
- Coordinates the systematic reviews of the various departments' HIPAA compliance status.
Performs related duties as assigned.
REQUIRED EDUCATION:
A Bachelor's degree in Business Administration, Healthcare Administration, Public Administration or related field or a Juris Doctorate.
REQUIRED EXPERIENCE:
Eight (8) years of professional experience working in compliance, healthcare, or law with a proven track record in healthcare regulatory matters.
REQUIRED LICENSE(S).
A valid State of Michigan D