The Compliance Officer implements the PHHS Compliance Program, which functions as an independent and objective body that reviews and evaluates compliance issues/concerns within the organization. The position reports to the Lead Compliance Officer and ensures that management and employees are in compliance with the rules and regulations of regulatory agencies, that Tribal and Divisional policies and procedures are being followed, and that behavior in the organization meets the Tribe's and Division's Standards of Conduct. This position monitors and reports results of the compliance/ethics efforts of the organization to the Lead Compliance Officer and provides guidance to the senior management team, as delegated, on matters relating to compliance. The Compliance Officer, together with the EBCI Office of Internal Audit, is authorized to implement all necessary actions to ensure the achievement of the objectives of an effective compliance program under the supervision of the Lead Compliance Officer.
- Develops, initiates, maintains, and revises policies and procedures for the general operation of the Compliance Program and its related activities to prevent illegal, unethical, or improper conduct as designated by the Lead Compliance Officer.
- Manages day-to-day operations of the Program.
- Develops and periodically reviews and updates Standards of Conduct to ensure continuing currency and relevance in providing guidance to management and employees.
- Collaborates with the EBCI Office of Internal Audit to direct compliance issues to appropriate existing channels for investigation and resolution as directed by the Lead Compliance Officer.
- Consults with the Attorney General's Office as needed to resolve difficult legal compliance issues when directed by the Lead Compliance Officer.
- Responds to alleged violations of rules, regulations, policies, procedures, and Standards of Conduct by evaluating or recommending the initiation of investigative procedures.
- Develops and oversees a system for uniform handling of such violations. Acts as an independent review and evaluation body to ensure that compliance issues/concerns within the organization are being appropriately evaluated, investigated, and resolved.
- Monitors, and as necessary, coordinates compliance activities of other departments to remain abreast of the status of all compliance activities and to identify trends.
- Identifies potential areas of compliance vulnerability and risk; develops/implements corrective action plans for resolution of problematic issues, and provides general guidance on how to avoid or deal with similar situations in the future.
- Monitors and takes appropriate measures to ensure PHHS is not doing business with any individual or entity that has been sanctioned, debarred or otherwise excluded from participation in Federal or State funded health care programs.
- Conducts annual compliance audits for billable entities of the PHHS Division.
- Maintains and updates the PHHS compliance plans in accordance with the Office of Inspector General's recommendations.
- Attends quarterly Compliance Committee meetings to ensure communication of compliance efforts are relayed to all levels of the division as designated by the Lead Compliance Officer.
- Maintains confidentiality and adheres to HIPAA and the HITECH Act law and regulations. Conducts HIPAA privacy and security investigations to ensure no Federal regulations have been violated.
- Provides reports on a regular basis, and as directed or requested, to keep the senior management informed of the operation and progress of compliance efforts.
- Ensures proper reporting of violations or potential violations to duly authorized enforcement agencies as appropriate and/or required.
- Establishes and provides direction and management of the compliance Hotline. Institutes and maintains an effective compliance communication program for the organization, including promoting (a) use of the Compliance Hotline; (b) heightened awareness of Standards of Conduct, and (c) understanding of new and existing compliance issues and related policies and procedures.
- Works with the Human Resources Department and others as appropriate to develop an effective compliance training program, including appropriate introductory training for new employees as well as ongoing training for all employees and managers.
- Monitors the performance of the Compliance Program and relates activities on a continuing basis, taking appropriate steps to improve its effectiveness.
- Develops goals and objectives aligned with PHHS mission, vision, and values using Results-Based Accountability (RBA).
- Provides supervision to staff within the Regulatory and Compliance as designated by the Lead Compliance Officer.
- Provides assistance as requested to respective program management staff in defining and resolving service delivery problems.
- Serves as liaison with State Centers for Medicaid and Medicare (CMS), Federal funding offices, and EBCI Office of Internal Audit.
- In the event of a Public Health Emergency, may be reassigned duties as necessary.
- Performs the basic licensing process for foster care homes, including receiving and responding to pre-application inquiries, reviewing background checks, and reviewing fire, safety, and environmental evaluations.
- Conducts on-site assessments of the provisionally or fully licensed homes at least quarterly, processes waiver requests, documents any findings during on-site visits, and formulates recommendations, denial/revocation requirements, or injunctive actions. Enters each new applicant into the Regulatory and Compliance Foster Care Licensure Tracker/Spreadsheet and monitors when on-site visits are due, re-licensure is due, etc.
- Cooperates with other specialists and regulatory agencies, such as fire marshals, building inspectors, sanitarians, teachers, public health nurses, the Office of the Attorney General, and any other Divisions of the Executive Branch as required.
- Provides quality assurance and approval of foster parent medical documentation.
- Creates and signs off on provisional licensure (up to six (6) months) and full licensure certificates which designate who the foster family is, where it is located, the date it is licensed, and how many children can receive foster care in the home (at that specific address).
- Must meet Public Health Core Competency Domains as determined by Program Manager within 12 months of employment.
This position is supervised by program leadership. This position is not responsible for supervising others.
Experience: Three (3) years of related experience required. Experience to include in a healthcare or human service organization, demonstrated experience with operational, financial, quality assurance, and human resource procedures.
Education: Master’s Degree in related field required.
Licenses & Certifications: Valid, insurable NC Driver’s License required.
* Disclaimer Statement
This is not intended to be an all-inclusive list of job-related responsibilities, duties, skills, requirements or working conditions. Other duties may be assigned based on business need and the supervisor’s request.
EBCI reserves the right to revise the position description at any time. Designated positions may be required to assist in emergency and/or disaster situations. Complete job description is found on application site.
PHHS
15 Exempt
ALL JOB POSTINGS CLOSE AT 11:59PM EST ON THE CLOSE DATE.
