Compliance Advisor

BBSI Portland; Oregon (WI); Hybrid; USD 80,000 - 110,000; Full time

Job summary

BBSI Portland is looking for a Clinical Quality & Compliance Advisor to join our hybrid team. You will oversee clinical audits, ensure compliance with Medicaid documentation, and lead client grievance processes. The ideal candidate holds a Master’s degree in Social Work, Counseling, or Psychology, along with an active Oregon license. You'll work collaboratively with leadership to enhance practice standards, maintain accreditation, and guide a small administrative team. This role emphasizes the importance of quality care and teamwork in a supportive environment.

Qualifications

• 5+ years of experience in behavioral health with compliance and auditing focus.
• Experience with Medicaid systems and documentation standards.
• Proven ability to interpret OARs and ORS for policy development.

Responsibilities

• Conduct clinical and documentation audits with Medicaid compliance focus.
• Manage insurance audit communications and responses.
• Advise on regulatory obligations and accreditation standards.

Skills

Behavioral health compliance

Audit tools development

HIPAA regulations

Collaboration

Communication skills

Education

Master's degree in Social Work, Counseling, or Psychology

Active Oregon licensure (LCSW, LPC, or LMFT)

Tools

EHR systems

Job description

Hybrid | Private Group Mental Health Practice

About the Role

We are seeking a Clinical Quality & Compliance Advisor who brings both clinical expertise and a genuine commitment to people — clients and colleagues alike. This hybrid, advisory-level position works directly with clinical and operational leadership within a private group mental health practice, influencing practice standards and compliance readiness through expertise and collaboration rather than direct HR authority.

We are looking for someone who leads with curiosity over judgment, communicates directly and kindly, and believes that quality care starts with a supported and well‑resourced clinical team. The ideal candidate understands that compliance isn’t just about rules — it’s about protecting clients, upholding integrity, and helping clinicians do their best work. This role is a strong fit for a licensed clinician who holds themselves to high ethical standards, takes compliance seriously as an act of care, and is motivated by building systems that help diverse teams do their best work.

This position is embedded within a collaborative clinical team where decisions are made together, perspectives are valued, and no one is working in isolation. If you thrive in an environment where your voice contributes to real clinical and operational outcomes alongside colleagues who are equally invested in quality care, this role is for you.

If you are someone who assumes goodness, speaks up when something feels off, and is committed to integrity even when it’s uncomfortable, you’ll fit right in here.

What You'll Focus On

Audit Oversight

Conduct and oversee clinical and documentation audits with a strong emphasis on Medicaid compliance, reviewing patient records for accuracy, completeness, and adherence to Medicaid documentation standards, billing requirements, and managed care organization guidelines. Develop and maintain audit tools, tracking systems, and reporting dashboards to monitor compliance trends. Identify risks, discrepancies, and patterns of concern and present findings and corrective action recommendations directly to leadership.

Insurance Audit Liaison & Quality Response

Serve as the primary point of contact for external insurance audits, managing communication with payers and ensuring the practice responds thoroughly and professionally to all audit requests. Translate audit findings into meaningful action by leading the development and implementation of corrective responses — which may include updating clinical documentation templates, refining documentation processes, revising and communicating policies and procedures, and designing and delivering targeted staff training to address identified gaps.

Regulatory Advisory & Compliance

Advise practice leadership on regulatory obligations, managed care requirements, and accreditation standards. Serve as the internal subject matter expert ensuring the practice meets all applicable Oregon state and federal compliance expectations. Oversee patient rights and grievance procedures and participate in the Health & Safety Committee.

Oversee the intake, tracking, and resolution of client grievances, ensuring all concerns are addressed promptly, thoroughly, and in accordance with applicable regulations and practice policies. Serve as a central point of contact for grievance procedures, maintaining documentation of outcomes and communicating patterns and trends to leadership to inform quality improvement efforts.

Licensing, Accreditation & Certification

Support the practice in maintaining all requirements as a certified Medicare and Medicaid site, ensuring ongoing adherence to applicable standards and regulations. Assist in developing and implementing processes and standards that support continued certification. Serve as the primary liaison for licensing and accreditation agencies, prepare for and host site reviews, and ensure timely completion and communication of all corrective action plans (CAPs).

HIPAA Information Officer

Serve as the designated HIPAA Information Officer — overseeing privacy and security compliance, responding to potential violations, educating staff on obligations, and maintaining all required documentation.

Policy & Procedure Development

Develop, revise, and maintain clinical and operational policies and procedures by interpreting and applying Oregon Administrative Rules (OARs), Oregon Revised Statutes (ORS), and insurance and managed care requirements. Ensure all policies reflect current regulatory standards and are written in a way that is clear, accessible, and actionable for clinical staff. Champion Continuous Quality Improvement (CQI) principles across the practice.

Quality Management & Data Oversight

Utilize clinical and operational data to identify quality issues, improvement opportunities, and monitor progress. Data sources include patient satisfaction surveys, referent satisfaction surveys, engagement and retention outcomes, incident reports and grievances, and internal chart audits. Evaluate the effectiveness of the Quality Management Program annually and present findings in an Annual Quality Improvement Report.

Produce monthly and quarterly reports for clinical staff that highlight documentation trends, compliance gaps, and quality benchmarks. These reports serve as a practical, supportive resource to help clinicians maintain strong documentation habits and ensure the practice consistently delivers high‑quality care. Findings are communicated to leadership and used to guide ongoing staff development and quality improvement efforts. Work collaboratively with the clinical management team to ensure any audit findings are corrected and implemented staff wide.

Administrative Team Oversight

Direct the day‑to‑day work of a small administrative support team, assigning tasks, setting priorities, and ensuring quality and compliance standards are reflected in their work. Provide regular feedback and professional development support to team members, and participate as part of the hiring team when bringing on new administrative staff. Personnel decisions such as termination are handled in partnership with HR.

Staff Training & Development

Design and facilitate training programs grounded in current clinical best practices, compliance standards, and documentation requirements. Build team competency in a way that reflects a belief in people’s capacity to grow — offering education as a resource, not a consequence.

What We're Looking For

• Master’s degree in Social Work, Counseling, Psychology, or related field
• Active, unrestricted Oregon licensure (LCSW, LPC, or LMFT)
• 5+ years of experience in a behavioral health setting with a focus on compliance, auditing, or quality improvement
• Extensive experience working within Medicaid systems, including documentation standards, billing compliance, utilization review, and managed care requirements
• Demonstrated ability to read, interpret, and apply OARs, ORS, and insurance requirements to develop and maintain policies and procedures
• Working knowledge of HIPAA privacy and security regulations
• Proven ability to develop and maintain audit tools, tracking systems, and reporting dashboards
• Experience with licensing, accreditation, and certification processes for Medicare and Medicaid sites
• Experience managing client grievance processes and patient rights compliance
• Experience providing oversight, task direction, and feedback to a small team
• A natural collaborator who thrives in a team environment and contributes meaningfully to shared clinical and operational decision‑making
• Warm, approachable, and supportive interpersonal style with the ability to build genuine trust with clinical staff
• Strong advisory and communication skills — able to influence without direct authority
• Committed to equity, inclusion, and affirming practice environments
• Ability to deliver honest, constructive feedback with kindness and clarity
• Familiarity with EHR systems and clinical documentation standards
• Comfortable working independently in a hybrid environment