Director, Clinical Compliance
Company: onehome
Location: Miramar
Posted on: May 10, 2022
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Job Description:
onehome is looking for a Clinical Compliance Director to leads
the coordination and collaboration to ensure compliance with
regulatory and accrediting quality of care and service
requirements. This Role will oversee the development of tools that
assist in determining exposure to regulatory and accreditation
risks and identifies opportunities to manage and mitigate those
risks. Collaborates with teams and business management areas to
develop metrics for monitoring program objectives, policies, and
procedures that support regulatory and accreditation standards
compliance.
onehome meets the needs of health plans by serving its members
through a value-based, full-risk model for integrated post-acute
and home-based care. Patients, plans, and providers have the same
goal - healing at home. onehome has built a model that combines
clinical and benefits management expertise under one roof to unlock
the promise of better care for everyone. onehome's model offers a
single point of accountability for care in the home to its health
plan and provider partners, serving more than one million health
plan members nationwide. As demand for care in the home has grown,
onehome's mission of bringing healing home will be instrumental in
helping to improve patient outcomes and quality of life, reducing
hospital readmission rates, and lowering costs. Visit us online at
onehome and follow us on LinkedIn and Twitter.
Responsibilities:
Leads the coordination and collaboration with internal business
partners and external regulators to ensure compliance with
regulatory, accrediting, and quality of care and service
requirements.
Develops tools that assist in determining exposure to regulatory
and accreditation risks and identifies opportunities to manage and
mitigate those risks within the annual corporate compliance audit
schedule
Conducts and oversees the internal audits to assess the strength of
internal controls against regulatory, accreditation and state
clinical operations standards.
Tracks and drives timely remediation of deficiencies identified
internally and externally
Develops detailed reports specifying compliance issues identified
during the audit.
Collaborates with teams and business management areas to develop
metrics for monitoring program objectives, policies, and procedures
that support regulatory and accreditation standards compliance.
Provides input to internal business leaders on the development of
Annual Utilization Management Program review
Assists with education initiatives (e.g. professional development
programs, process improvement initiatives, recruiting, and special
projects as requested).
Advises the internal business partners on activities and clinical
strategies related to quality improvement and compliance monitoring
activities.
Recommends improvements or remediation to risk management,
regulatory, and accreditation compliance programs.
Supports and provides audit reports in the compliance and quality
committees.
Leads department projects and serves as a subject matter
expert.
Skills/Qualifications:
- RN/BSN, ST, PT, OT
- Hospital Quality, Risk Management, Infection Prevention, Case
Management, Utilization Management, Post-acute services, and/or
consulting experience is preferred
- Medicare, NCQA, JCAHO, ACHC, AHCA and CMS
- A Bachelor's degree in healthcare management or administration is
highly desired
Reasonable accommodations may be made to accommodate individuals
with disabilities to perform the basic functions of the position
without compromising client care. onehome LLC is an Equal
Opportunity/Affirmative Action Employer and is committed to
providing a drug-free workplace. We are an Equal-Opportunity
Employer and do not discriminate against any employee or applicant
for employment because of race, color, sex, age, national origin,
religion, sexual orientation, gender identity, status as a veteran,
and basis of disability or any other federal, state, or local
protected class.
Keywords: onehome, Hollywood , Director, Clinical Compliance, Executive , Miramar, Florida
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