Senior Compliance & Training Manager

Amity Foundation•Los Angeles, CA

4d•$90,000 - $90,000

About The Position

Amity Foundation is a safe place where people can change in an environment that fosters trust; where new values can be formed; responsibility developed and lasting relationships built. Amity is dedicated to the inclusion and habilitation of people marginalized by addiction, homelessness, trauma, criminality, incarceration, poverty, racism, sexism, and violence. Amity is committed to research, development implementation, and dissemination of information regarding community building. Remembrance, Resolution, Reconciliation, Restoration, Renewal The Sr Compliance Manager for the Enhanced Care Management (ECM)-Community Supports (CS) program is responsible for the compliance of these projects. ECM is a comprehensive, patient-centered approach to healthcare that aims to improve outcomes for high-need populations. This involves the coordination of medical, behavioral, and social services to address the full range of patient needs, focusing on those with complex and chronic conditions. ECM programs are designed to optimize care delivery, reduce unnecessary hospitalizations, and improve the overall quality of life for students. The Sr Compliance Manager supervises QA, Data, and Community Supports staff involved in maintaining both paper and Electronic Health Record (EHR) documents and files for Students, including compliance, Medi-Cal billing, and contract oversight for all Managed Care Plans (MCP) and contracted counties. The Sr Compliance Manager reports to the Program Director.

Requirements

(EHR) and Preferred: Masters level degree, preferably in Social Services or related field, Minimum Bachelor's level degree, preferably in Social Services or related field.
High level of organizational and analytical skills.
Ability to understand or learn Medi-Cal regulations and principles.
Basic understanding of Title 22 principles.
Must meet the requirements to be an eligible Amity Foundation driver. Must possess a current State Driverâs License and have an acceptable driving record for the past three (3) years.
Excellent attention to detail and the ability to manage complex information with high accuracy.
Strong organizational and time-management skills.
Proficiency with data entry, electronic health record systems, and Microsoft Office suite.
Effective written and verbal communication skills.
Driverâs License
Excellent interpersonal and communication skills and the ability to work effectively with a wide range of constituencies in the community and within the organization.
Knowledge of contract parameters, objectives, milestones, and other deliverables.
Knowledge of contracting process and associated local, state, federal, and other regulations.
Ability to integrate budgetary and service utilization data, forecast expenditures, and respond to ensure both effective provider utilization and budget compliance.
Ability to multitask, identify problems, provide recommendations to management teams, and implement any applicable systems.
Ability to work constructively with diverse people and with parties that may have divergent perspectives and interests.
Ability to clearly express concepts and direction, both orally and in writing, and to prepare complex reports, policies, and procedures.
Understand and appropriately apply Amity policies and procedures and adhere to agency-wide practices and regulations.
Strong oral and written communication skills.
Proficient with software such as Microsoft Office Suite (Word, Excel. Email, Internet, etc.).
Ability to utilize resources available to complete assigned projects.
Ability to prepare written reports and correspondence.
Ability to effectively communicate, verbally and in writing.
Able to work in excess of 40 hours per week with the possibility of a varied schedule
Must be able to maintain a high level of confidentiality.
Ability to build and maintain positive internal and external relationships.
Ability to provide exemplary customer service to all employees and outside constituents.
Ability to function independently and as a member of a team in a multi-task environment.
Must be flexible and able to handle multiple priorities, with the ability to adjust to high pressure and rapidly changing business conditions.

Nice To Haves

Experience with managing reports and reviewing services prior to claim submission in a behavioral healthcare setting is a plus.

Responsibilities

Responsible for providing supervision and training to the Quality Assurance, Data, and Community Supports supervisors and staff.
Serves as the organizationâs subject matter expert for ECM/CS regulatory compliance
Responsible for overseeing all billing system entries for assigned programs in coordination with program QA staff
Monitor Medi-Cal, MCP contract-specific documentation of ECM and CS Direct Service Staff.
Advises executive leadership on compliance risk, regulatory changes, and corrective actions.
Collaborate with the accounting department regarding billing and invoicing systems.
Liaison with various county personnel to ensure ongoing collaboration, address concerns, and rectify any issues.
Liaison with LCM care team, MCP, and ECM Management team to ensure that both the needs of the program and the needs of staff are being met promptly.
Leads the design, implementation, and continuous improvement of the compliance framework
Oversee Internal Audits of each program to assess for Medi-Cal, contract, and agency compliance.
Participate in the development of training focusing on documentation and compliance.
Oversee QA, Data, and CS development within new programs created within the agency
Ensure programmatic understanding of contracts and serve as the primary point person for all contract compliance issues.
Conducts annual Quality Assurance, Data, and CS Program Element review.
Attends all integrated monitoring by the Amity Foundation Quality Assurance Team and licensing agencies.
Conducts internal monitoring, auditing, and periodic risk assessments at each county ECM and CS site to ensure all employees are trained and compliant with licensing and state regulations.
Identifies potential areas of compliance vulnerability and risk; develops corrective action plans.
Conducts timely reviews of Each Managed care plan policy, procedure, and Medi-Cal information to ensure it is up to date.
Responsible for training service-providing program managers on contract requirements for service delivery.
Completes required reports and documentation on time, provides management with required reports, and advises of any problematic situations.
Ensures the highest standards are maintained to prevent illegal, unethical, or improper conduct and to ensure the program remains in compliance with The Health Insurance Portability and Accountability Act (HIPAA) and Protected Health Information (PHI) and in accordance with state licensing regulations.
Assists with the correction of deficiencies and quality improvement efforts.
Ensures the safety, health, and welfare of staff and students at all times.
Models and ensures all program norms are upheld without compromise.
Other Duties as assigned.