Compliance Associate
Riverside, RI Riverside, RI Full-time Full-time $25 - $27 an hour $25 - $27 an hour Job
Summary:
The Compliance Associate role is an integral part of achieving organizational quality and compliance by educating staff on regulatory requirements, setting documentation standards, and auditing medical records and operational workflows.
The Compliance Associate works under the supervision of the Senior Director of Compliance and Quality, is a member of the Organizational Performance team, and works in close collaboration with the Health Center and Medical staff.
The Compliance Associate will develop and maintain in-depth knowledge of regulatory requirements as determined by federal, state, accrediting bodies, and PACE-RI internal policies.
This role educates staff proactively and in response to questions and issues and performs audits of medical charts and organizational processes to ensure compliance.
Results of the auditing are reported to management and other staff on a regular basis.
The Compliance Associate will uphold processes that prevent fraud, waste, and abuse, and conduct investigations as needed.
Most essential to this role is a commitment to the organization's mission of providing high quality care to the participants enrolled in PACE-RI, and an understanding of how compliance is the underpinning of quality.
Duties/
Responsibilities:
Maintains all licensing requirements for homecare, adult day, kitchen, and clinical areas Actively participates in the CMS survey process from start to finish including survey preparation, staff education, mock survey, etc.
Performs regular audits of internal departments to ensure compliance with state and federal regulations and internal policies and procedures Reads and organizes any and all NPA Memos and delegates responsibilities to staff as needed.
Completes regular summary reports of compliance activities.
Makes recommendations for actions to be taken to correct weaknesses or to improve strengths.
Maintains PACE-RI's policy and procedure manuals and oversees the development, revision and annual review of policies and procedures.
Assists in the preparation of appeals and responses to denials from third party payers.
Assists with the coordination and delivery of required education, orientation and enhanced learning experiences for staff and professional students.
Collaborates with Contract Manager in the preparation for CMS audit of contracted personnel and entities.
Use reports to identify areas of non-compliance with process or regulations; bring clinical issues to the attention of Health Center Manager and/or CMO promptly.
Maintain knowledge of internal processes, regulatory requirements, and quality standards and practices to serve as a resource to IDT, health center and medical teams.
Collaborate with Quality Specialist to create improvement processes in areas where improved compliance is needed to impact quality metrics Develop and maintain proficiency in use of the EMR in order to run reports, audit records, and advise medical and health center teams on best usage.
Engage in survey preparation for any State and Federal agency by providing support in data collection, analysis, and explanation.
Communicate findings to stakeholders using documented best practices for visualization.
Performs other related duties as required and assigned.
Qualifications:
Bachelor's Degree, Required 1 to 3 years of EMR/EHR experience, Preferred 1 to 3 years of Health Care Industry Experience, Preferred Interest in maintaining the health and dignity of the older adult population Proficiency in Microsoft Excel required Driver's License & access to reliable transportation:
community-based travel required.
About the PACE Organization of Rhode Island:
With a mission to blend and deliver medical and social care for older adults with significant health needs who want to continue living at home, the PACE Organization of Rhode Island provides Community-Based Health Care and Support Services in order to ensure the needs of our participants are fully met through a plan of care that is specific to each and every person.
PACE-RI is dedicated to the values of equal employment opportunity and strives to develop and cultivate a diverse and knowledgeable workforce dedicated to its mission.
All applicants will be considered on the basis of their qualifications and ability to perform the job successfully.
Benefits:
PACE-RI offers a full benefits package which includes Medical, Dental, Vision, 403b with 3% match, Life Insurance, AD&D Insurance, Voluntary Life Insurance, Flexible Spending Account options, 11 Paid Holidays, and Paid Time Off (including your birthday).
Job Type:
Full-time Pay:
$25.
00 - $27.
00 per hour
Benefits:
401(k) matching Dental insurance Employee assistance program Flexible spending account Health insurance Life insurance Paid time off Vision insurance Schedule:
8 hour shift Monday to Friday No weekends Application Question(s):
What is your anticipated starting wage? Education:
Bachelor's (Preferred)
Experience:
EMR systems:
1 year (Preferred) Health Care industry:
1 year (Preferred) Microsoft Excel:
1 year (Preferred) Work Location:
In person.
Estimated Salary: $20 to $28 per hour based on qualifications.
Summary:
The Compliance Associate role is an integral part of achieving organizational quality and compliance by educating staff on regulatory requirements, setting documentation standards, and auditing medical records and operational workflows.
The Compliance Associate works under the supervision of the Senior Director of Compliance and Quality, is a member of the Organizational Performance team, and works in close collaboration with the Health Center and Medical staff.
The Compliance Associate will develop and maintain in-depth knowledge of regulatory requirements as determined by federal, state, accrediting bodies, and PACE-RI internal policies.
This role educates staff proactively and in response to questions and issues and performs audits of medical charts and organizational processes to ensure compliance.
Results of the auditing are reported to management and other staff on a regular basis.
The Compliance Associate will uphold processes that prevent fraud, waste, and abuse, and conduct investigations as needed.
Most essential to this role is a commitment to the organization's mission of providing high quality care to the participants enrolled in PACE-RI, and an understanding of how compliance is the underpinning of quality.
Duties/
Responsibilities:
Maintains all licensing requirements for homecare, adult day, kitchen, and clinical areas Actively participates in the CMS survey process from start to finish including survey preparation, staff education, mock survey, etc.
Performs regular audits of internal departments to ensure compliance with state and federal regulations and internal policies and procedures Reads and organizes any and all NPA Memos and delegates responsibilities to staff as needed.
Completes regular summary reports of compliance activities.
Makes recommendations for actions to be taken to correct weaknesses or to improve strengths.
Maintains PACE-RI's policy and procedure manuals and oversees the development, revision and annual review of policies and procedures.
Assists in the preparation of appeals and responses to denials from third party payers.
Assists with the coordination and delivery of required education, orientation and enhanced learning experiences for staff and professional students.
Collaborates with Contract Manager in the preparation for CMS audit of contracted personnel and entities.
Use reports to identify areas of non-compliance with process or regulations; bring clinical issues to the attention of Health Center Manager and/or CMO promptly.
Maintain knowledge of internal processes, regulatory requirements, and quality standards and practices to serve as a resource to IDT, health center and medical teams.
Collaborate with Quality Specialist to create improvement processes in areas where improved compliance is needed to impact quality metrics Develop and maintain proficiency in use of the EMR in order to run reports, audit records, and advise medical and health center teams on best usage.
Engage in survey preparation for any State and Federal agency by providing support in data collection, analysis, and explanation.
Communicate findings to stakeholders using documented best practices for visualization.
Performs other related duties as required and assigned.
Qualifications:
Bachelor's Degree, Required 1 to 3 years of EMR/EHR experience, Preferred 1 to 3 years of Health Care Industry Experience, Preferred Interest in maintaining the health and dignity of the older adult population Proficiency in Microsoft Excel required Driver's License & access to reliable transportation:
community-based travel required.
About the PACE Organization of Rhode Island:
With a mission to blend and deliver medical and social care for older adults with significant health needs who want to continue living at home, the PACE Organization of Rhode Island provides Community-Based Health Care and Support Services in order to ensure the needs of our participants are fully met through a plan of care that is specific to each and every person.
PACE-RI is dedicated to the values of equal employment opportunity and strives to develop and cultivate a diverse and knowledgeable workforce dedicated to its mission.
All applicants will be considered on the basis of their qualifications and ability to perform the job successfully.
Benefits:
PACE-RI offers a full benefits package which includes Medical, Dental, Vision, 403b with 3% match, Life Insurance, AD&D Insurance, Voluntary Life Insurance, Flexible Spending Account options, 11 Paid Holidays, and Paid Time Off (including your birthday).
Job Type:
Full-time Pay:
$25.
00 - $27.
00 per hour
Benefits:
401(k) matching Dental insurance Employee assistance program Flexible spending account Health insurance Life insurance Paid time off Vision insurance Schedule:
8 hour shift Monday to Friday No weekends Application Question(s):
What is your anticipated starting wage? Education:
Bachelor's (Preferred)
Experience:
EMR systems:
1 year (Preferred) Health Care industry:
1 year (Preferred) Microsoft Excel:
1 year (Preferred) Work Location:
In person.
Estimated Salary: $20 to $28 per hour based on qualifications.
|
|
 | |
