Job Description
Summary/Objective
The Compliance Officer is a director-level position responsible for overseeing and managing the compliance function across the organization, ensuring adherence to legal and regulatory requirements, promoting ethical practices, and fostering a culture of compliance. The compliance Officer is responsible for operationalizing all 7 elements of an effective compliance program. The organization provides integrated health and human services to special populations, including individuals with Intellectual and Developmental Disabilities (I/DD) and Behavioral Health (BH) needs. The Compliance Officer works under the Chief Legal Officer & General Counsel (CLOGC) and the Senior Director of Compliance, Quality, Training and Access (SDCQTA) and collaborates closely with other departments to support the organization’s mission and strategic goals.
Essential Functions
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
1.Compliance Program Leadership:
o Develop, implement, and maintain a effective compliance program that aligns with the organization’s mission and regulatory requirements.
o Ensure compliance program addresses applicable federal, state, and local laws and regulations, particularly those related to healthcare services, Medicaid, and other relevant areas, in a reasonable manner for the function to prevent, detect, and correct noncompliance issues.
o Lead efforts to create and update a code of conduct and policies & procedures that address compliance risks, ensuring these documents reflect current legal standards and organizational objectives.
2.Risk Management and Auditing:
o Work closely with the CLOGC, Risk Manager, and other key stakeholders to identify, assess, and mitigate risks identified.
o Partner and work collaboratively with the Compliance Manager to further develop and manage an Auditing & Monitoring Dashboard to track internal and external audit activities, compliance with regulations, and effectiveness of corrective actions.
o Establish a formal, project management-focused process for correcting noncompliance and conducting risk assessments, documenting identified risks, and prioritizing them based on severity and likelihood.
3. Policies and Procedures:
o Lead the development, implementation, and regular review of compliance policies and procedures, ensuring they are aligned with the organization’s goals and regulatory requirements.
o Partner with various departments and create compliance reporting demonstrating compliance with expectations to ensure that policies are understood, properly implemented, and regularly updated as needed.
4. Corrective Action and Continuous Improvement:
o Develop and oversee a comprehensive corrective action process that tracks issues identified through audits, monitoring activities, incident reports, or any other mechanism.
o Ensure that corrective actions are effectively documented, assigned ownership, monitored, and evaluated for impact, supporting continuous improvement across the organization.
5. Data Governance and Reporting:
o Establish and maintain a data governance framework that ensures the accuracy, consistency, and timeliness of data used for compliance reporting and decision-making.
o Collaborate with the analytics team to integrate data platforms for real-time insights, trend analysis, and informed decision-making.
6. Communication and Training:
o Develop and deliver targeted compliance training programs for employees at all levels, ensuring that staff are knowledgeable about relevant laws, regulations, and company policies.
o Partner with the Compliance Manager to produce and distribute compliance newsletters that provide relevant updates, compliance tips, and regulatory changes tailored to specific departments.
7. HIPAA Privacy Compliance:
o Lead efforts to address gaps identified in HIPAA privacy , developing comprehensive policies and procedures to protect sensitive information.
o Be a partner for the Information Technology and Analytics team building the HIPAA security rule compliance framework.
o Build systems and processes to report whether the organization complies with all applicable privacy and security regulations, including regular training and awareness initiatives.
8. Governance and Compliance Effectiveness:
o Work with GLOGC and SDCQTA to evaluate the effectiveness of the compliance program, benchmarking against industry standards and best practices.
o Implement governance process oversight to ensure timely renewals of certifications, licenses, and other critical compliance obligations
Required and Preferred Education and Experience
•Education & Certification:
o Bachelor’s degree in healthcare administration, business, or a related field required.
o Advanced degree or relevant professional certifications (e.g., Juris Doctor or Master’s in Healthcare Administration) preferred but not required.
o Certification in Healthcare Compliance (CHC) from the Health Care Compliance Association (HCCA) preferred but not required.
• Experience:
o 10 years of experience in compliance leadership, preferably within a healthcare or human services environment.
o 5-10 years supervisory experience in compliance or a related field
o Extensive knowledge of laws and regulations related to I/DD, Behavioral Health, and integrated care services.
o Demonstrated experience in managing compliance programs, including policy development, risk management, and auditing processes.
• Skills and Competencies:
o Strong analytical, communication, and leadership skills.
o Proven ability to manage multiple projects and prioritize tasks effectively.
o Ability to work independently and collaboratively across departments.
o Commitment to ethical conduct and continuous improvement.
Supervisory Responsibilities:
The Compliance Officer supervises compliance staff and may oversee other team members involved in compliance-related tasks. The role also includes working closely with the CLOGC and SDCQTA and other department leaders to provide guidance on compliance matters.
Work Environment:
This role primarily operates remote work. Occasional travel may be required for site visits, audits, or external meetings.
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