The Compliance Associate will provide oversight of organizational compliance with regulatory and performance improvement standards as determined by federal, state, accrediting bodies, and the PACE Organization of Rhode Island. In close coordination with the Chief of Organizational Performance, the Compliance Associate oversees development, implementation, and oversight of PACE-RI’s corporate compliance/risk management, and regulatory accreditation programs and activities.
- Provide support in complying with regulations related to patient privacy and protected health information or delegates this role and works closely with Privacy Officer.
- Participates in PACE-RI’s quality improvement program consistent with PACE-RI strategic goals.
- Maintains all licensing requirements for homecare, adult day, kitchen, clinical, and the Final Rule.
- Establishes an organizational system for timely filing of license applications and accurately monitors timeline for submission.
- Manages 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.
- Reads and organizes any and all NPA Memos and delegates responsibilities to staff as needed.
- Ensures successful completion of HOS-M Survey.
- Coordinates and facilitates outcome oriented, goal-directed compliance improvement teams.
- Utilizes quantitative performance measurement techniques, analyzes data, and sets benchmark standards to establish a solid foundation of facts, statistics, and data for tracking quality improvement outcomes.
- Completes regular summary reports of performance improvement and compliance activities. Makes recommendations for actions to be taken to correct weaknesses or to improve strengths.
- Oversees PACE-RI compliance with state, federal and accreditation standards.
- Maintains PACE-RI’s policy and procedure manual and oversees the development, revision and annual review of policies and procedures.
- Works with the CEO to develop implement and oversee PACE-RI’s corporate compliance program.
- Serves as a resource for PACE-RI corporate compliance program.
- Oversees PACE-RI’s corporate compliance questions and concerns.
- Oversees PACE-RI’s risk management activities including requests for medical information from any external parties.
- Assists in the preparation of appeals and responses to denials from third party payers.
- Assesses staff learning needs through an aggregation of annual competencies, staff surveys, new technology, changes in the health care industry and results of QI studies for new staff an on a regular basis, provides and/or oversees organization wide education and updates on quality improvement, fraud waste and abuse, privacy, corporate compliance, risk management and regulatory/accreditation standards and activities.
- Assists with the coordination and delivery of required education, orientation and enhanced learning experiences for staff and professional students.
- Facilitates compliance committee meetings and communication within organization and with Board and CEO. Serves as a member of the Compliance Committee of the Board.
- Participates in contract management oversight by participating in Contract Committee, review contracts for compliance and participates in responding to violations by vendors/partners.
- Bachelor’s Degree
- 3 years’ experience in health care organization
- Experience with electronic record systems
- Familiarity with health care regulations and reporting requirements
- Excellent verbal and written communication skills
- Able to work effectively at all levels in a collaborative team environment
- Service-oriented and solutions-focused mindset
PACE offers a full benefits package which includes Medical, Dental, Vision, 403b, Life Insurance, AD&D Insurance, Voluntary Life Insurance, Flexible Spending Account options, 10 Paid Holidays, and Paid Time Off (including your birthday).
About the PACE Organization of Rhode Island:
With a mission to preserve and sustain the independence of older adults who have significant health needs and wish to remain in the community, 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 is dedicated to the values of equal employment opportunity and strives to develop and cultivate a diverse and knowledgeable workforce dedicated to its mission to preserve and sustain the independence of older adults who have significant health needs and wish to remain in the community.
All applicants, including internal PACE applicants, will be considered on the basis of their qualifications and ability to perform the job successfully.