Director, Compliance

InnovAge; Denver (CO); Remote; USD 115,000 - 151,000; Full time

Job summary

An established industry player is seeking a Director of Compliance to lead its compliance and risk management initiatives. In this pivotal role, you will develop comprehensive programs while overseeing audit management and compliance education. Your expertise will ensure adherence to regulatory standards within a healthcare environment, fostering a culture of compliance across the organization. Join a dedicated team that empowers seniors to live independently while contributing significantly to their well-being. This position offers a dynamic work environment with opportunities for professional growth and collaboration.

Benefits

Medical/Dental/Vision Insurance

401(k) Savings Plan

Paid Time Off

Flexible Spending Accounts

Company-Paid Holidays

Short and Long-Term Disability

Life Insurance and AD&D

Supplemental Life Insurance

Qualifications

• Minimum 10 years of clinical experience in compliance or risk management.
• Excellent communication and presentation skills for diverse audiences.
• Experience managing teams and conducting regulatory investigations.

Responsibilities

• Develop and maintain compliance and risk management programs.
• Oversee audits and ensure adherence to regulatory standards.
• Manage compliance department and provide training initiatives.

Skills

Clinical Compliance

Risk Management

Data Analysis

Interpersonal Communication

Problem Solving

Education

Bachelor’s Degree in Related Field

Master’s Degree in Health Care

Tools

MS Word

MS Excel

MS Outlook

Job description

Responsibilities

Under the supervision of the Vice President of Compliance, the Director of Compliance is responsible for developing and maintaining a comprehensive compliance and risk management program along with overseeing the audit management program and resources, implementation of compliance education and training, and initiation of compliance projects to ensure organizational integrity. The position supports the Vice President of Compliance, in fulfilling her/his oversight role by providing management, oversight, and assessment of the clinical and operational practices of the organization in comparison to regulatory requirements.

Essential Functions and Work Responsibilities

Functional Category: Risk Management, Operational Compliance Oversight, and Compliance Audit Oversight

Estimated Percent of time Spent – 100%

• Manage the Compliance Department of the assigned area including direct supervision of the Compliance Audit Manager and SDAG Manager in alignment with the goals of the Compliance Program.

• Administers and provides recommendations to minimize risk and ensure the organization's compliance with standards, laws, rules and regulations applicable to the provision of healthcare, treatment and associated services.

• Perform and manage audits of documentation, functions, and departments in all business lines to ensure adherence to regulatory guidance.

• Oversee the organizational practices to assess compliance with regulations and government agencies regarding service documentation.

• Directs the day-to-day compliance and risk management activities including regulator communication, oversight of regulator deliverables, oversight of SDR, appeals, and grievances, investigating compliance allegations, and serves as a compliance and risk management resource for staff.

• Promptly investigate reports of non-compliance or suspected violations of non-compliance and implement corrective actions as deemed appropriate.

• Provides support, oversight, and final submission of the enrollment denial and voluntary/involuntary disenrollment process.

• Acts as a lead for all regulatory contact for PACE programs, CMS, State Administering Agencies, and State licensing agencies.

• Acts as the lead for regulatory surveys from notification through the closing of a corrective action plan.

• Increase communications with providers, operations, and nursing to establish working relationships which encourage consistency with compliance practices and expectations.

• Provides aid to team members for the oversight and coordination of concurrent and retrospective audits of documentation, departments and functions to ensure adherence to regulatory guidance.

• Reports deficiencies found during audits to the VP of Compliance and Chief Compliance Officer.

• Prepares requested reports by collecting, analyzing, and summarizing relevant information obtained through investigations, and other compliance activities.

• Ensure all policies and procedures in the practice setting adhere to applicable laws, rules, and regulations.

• Directs internal corrective action to reduce regulatory non-compliance.

• Participate in leadership meetings to promote compliance initiatives and respond to concerns raised.

• Assist with audit & compliance related special projects as requested.

• Develop audit processes and maintain audit tools for use in all lines of business.

• Manages the participant internal and external appeals process to ensure compliance with PACE and State regulations.

• Assists with policy and procedure development and maintenance.

• In collaboration with the Operations and the Education Department, designs and develops training initiatives/interventions to support compliance efforts and to address non-compliance.

• Participates in Level 2, Quality and Account Management meetings and calls with regulators

• Maintains current knowledge of regulatory guidance governing InnovAge entities and standards of compliant practice.

• Works in collaboration with Center leadership to communicate ongoing areas for oversight and non-compliance concerns.

• Performs other related duties as assigned

Travel Requirements

Travel

Estimated Percent of time Spent – 40%

• Travel between InnovAge worksites

• Overnight travel out of state as needed

Remote Work - 60%

Qualifications

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions

REQUIRED

Education

• Bachelor’s degree in related field or an equivalent combination of education and experience.

Licensure, Certification, Registration or Designation

• Must have a state issued driver’s license, personal transportation, good driving record and auto insurance as required by law

Work Experience and Qualifications

• Must have a minimum of ten years’ experience of applied clinical experience, compliance or clinical risk management in a health care provider related field.

• Five or more 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 with integration of clinical, operations, and financial data; development of audit, utilization and performance reporting tools; and communication of performance data to healthcare stakeholders

• Experience with telecommuting and remote monitoring

• Resourceful, highly organized self-starter with a bias towards action and efficiency

• Trusted, team player looking to drive success in a fast-paced environment

• Solid PC skills, specifically using MS Word, Outlook, and Excel

• Excellent oral, written, and interpersonal communication skills, facilitation skills

• Data analysis and interpretation aptitude

• Innovative problem-solving skills

• Excellent presentation skills for both clinical and non-clinical audiences

PREFERRED

Education

• Master’s degree in Health Care related field

Certification

• Compliance certification

Benefits

InnovAge is dedicated to empowering seniors to live independently, allowing them to age in their own homes and communities safely. InnovAge offers an alternative to nursing homes through its Program of All-inclusive Care for the Elderly (PACE), which provides enrolled seniors with customized healthcare and social support at PACE Adult Day Health Centers. These centers are staffed by medical professionals who are committed to creating personalized care plans for each participant. At InnovAge, our team members are our greatest asset and have a significant impact on the lives of our participants every day. When you join InnovAge, you'll work alongside talented, respectful, and passionate colleagues within a patient-centered care model.

InnovAge is committed to equal opportunity and affirmative action, and we strive to create a diverse and inclusive workplace. We consider all qualified candidates for employment without discrimination based on race, color, religion, sex, sexual orientation, gender identity/expression, national origin, disability, protected veteran status, pregnancy, or any other protected status. Salaries are determined by various factors such as qualifications, experience, and location, and do not include potential bonuses or benefits. Our extensive benefits package includes medical/dental/vision insurance, short and long-term disability, life insurance and AD&D, supplemental life insurance, flexible spending accounts, 401(k) savings, paid time off, and company-paid holidays.

Applicants are considered until the position is filled.

Posted Salary Range

115700-150500