Director, Clinical Compliance

Company: onehome
Location: Miramar
Posted on: May 10, 2022

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