Job Description:
• Develop and maintain a comprehensive compliance, audit management, and facility oversight plan for InnovAge PACE/LIFE Programs
• Lead compliance oversight, audit management, facility oversight, policy and procedure management, compliance education and training, and compliance projects
• Support the Chief Compliance Officer through oversight, management, and assessment of clinical and operational practices against regulatory requirements
• Implement corrective action plans addressing identified internal and external risk areas
• Perform and manage audits of documentation, functions, and departments across all business lines
• Manage Regional Directors of Clinical Compliance, Audit Management; Director of Facility Oversight; Compliance Coordinator; and augmented audit staff
• Promote a culture of compliance and serve as a compliance expert resource
• Assess organizational practices for compliance with regulations and government agency requirements regarding service documentation
• Build working relationships with providers, operations, and nursing
• Lead projects to identify and mitigate compliance issues
• Ensure practice-setting policies and procedures comply with applicable laws, rules, and regulations
• Participate in leadership meetings and respond to compliance concerns
• Investigate suspected non-compliance and implement corrective actions
• Develop audit processes and maintain audit tools across all lines of business
• Collaborate with Corporate Compliance to build an organization-wide culture of compliance
• Monitor federal and state regulations related to physician services and practices
• Translate complex clinical mandates into operational workflows
• Lead compliance initiatives for State Ready Reviews for new Centers
• Travel between InnovAge worksites, including approximately 40% travel and overnight out-of-state travel
Requirements:
• Eight to ten years of experience across clinical compliance and/or regulatory functions in a healthcare delivery or healthcare environment
• Three to five years of experience managing enterprise-level employees and/or teams
• Three to five years of experience conducting investigations to determine regulatory compliance
• Experience integrating clinical, operations, and financial data
• Experience developing audit, utilization, and performance reporting tools
• Experience communicating performance data to healthcare stakeholders
• Experience with telecommuting and remote monitoring
• Solid computer skills, specifically MS Word, Outlook, and Excel
• Excellent oral, written, and interpersonal communication skills
• Facilitation skills
• Data analysis and interpretation aptitude
• Innovative problem-solving skills
• Presentation skills for clinical and non-clinical audiences
• Familiarity navigating electronic medical record (EMR) systems to complete reviews
• Strong analytical skills and basic math skills
• Ability to work with multiple and diverse clients and projects
• Ability to work with minimal supervision
• Must have a state-issued driver’s license, personal transportation, safe driving record, and auto insurance as required by law
• Bachelor of Science / related field, or equivalent years of experience
• Nursing License, RN, preferred, or clinical equivalent
• Certification in Healthcare Compliance (CHC) preferred
Benefits:
• Medical/dental/vision insurance
• Short- and long-term disability insurance
• Life insurance and AD&D
• Supplemental life insurance
• Flexible spending accounts
• 401(k) savings / 401(k) plan with company match
• Paid time off
• Company-paid holidays
• Diverse and inclusive workplace
• Patient-centered care model
• Travel between InnovAge worksites and overnight out-of-state travel as part of the role