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Regional Compliance Officer
Under the supervision of the Regional Coordinator or designee, the Regional Compliance Officer is responsible for supporting consumers and providers by engaging in compliance management functions that serve to promote efficient and effective use of programmatic resources. This is accomplished by utilizing a combination of data analysis and on-site assessment intended to monitor provider treatment quality and develop provider networks that support comprehensive systems of care relative to Department Mission and Goals.
Compliance management functions include analysis of service utilization patterns, results achieved by providers, prevention/correction of treatment quality outlier issues, and education/technical assistance given to providers. Utilization patterns and achieved results may include review of consumer metrics includin recidivism/relapse patterns, mental/medical status changes, functional changes and satisfaction levels. Provider practice patterns and service design and delivery are monitored to assure satisfactory accessibility and to reduce under servicing of high risk groups, such as psople discharged from state hospitals and crisis stabilization programs and people at risk for hospitalization.
Job Responsibilities include:
Conduct site visits of MH, AD and DD providers and programs to review quality of services, programming and staffing plans and make recommendations to assure satisfactory accessibility and treatment quality
Educate providers, make recommendations to and provide trehnical assistance to providers regarding contract expectations and compliance management measures for MH, AD and DD providers and programs
Identify training needs for providers
Assure providers maintain compliance with all relevant Federal Block Grant requirements
Initiate, approve and monitor successful implementation of provider Corrective Action Plans. This may be either independent of, or in conjunction with, either Department contracted External Review Organization (ERO) or Department Compliance Section
Recruit new providers to contract with the Department to increase service capacity and support fully realized systems of care
Assist in processing new provider applications in conjunction with Central Office Provider Network Management Section
Monitor routine service utilization reports, contract billing reports and provider expenditure reports in conjunction with the Regional Financial Analyst to track over or under-utilization of services relative to contract allocations and deliverables
Prepare service utilization reports as requested by the Regional Coordinator or desingee
Support Department Compliance Section by assisting in regional provider compliance reviews as approved by the Regional Coordinator or designee
Manage transition of contract/LOA termination/non-renewal in conjunction with the Central Office and Regional Financial Analyst
Associate degree in a related field and five years experience with at least two years in a position directly related to the area of assignment OR Bachelors degree in a related field and four years of related experience OR Masters degree in a related field and two years of related experience OR two years experience at the lower level or a position equivalent
Note: Some positions may require a certification or licensures and some position may require a valid driver's license
Preference will be given to those who meet the following qualifications, in addition to the qualifications listed above:
Provider network development/management experience
Professional level Quality Management/Utilization Management experience
Training and consultation experience
Knowledge of behavioral health service design models
Experience in service systems being transitioned from facility-based to community-based models
PLEASE INDICATE WHICH REGION/LOCATION YOU ARE APPLYING FOR
In addition to a competitive salary (), we offer a generous benefits package that includes a flexible schedule, training opportunities, employee retirement plan, deferred compensation, 12 paid holidays, vacation and sick leave, dental, vision, long term care, and life insurance.
This position is a pay grade 16 on the statewide salary plan.
This position is located in the Region 3 Regional Office in Tucker, GA (DeKalb County).
A sprawling metropolis of over four million people today Metro Atlanta has the vibrancy of the world’s great urban centers combined with the Southern charm of small town centers such as Roswell and Decatur. Here you’ll find historic sites from the Civil War through the Civil Rights era, as well as world-class shopping, entertainment, and nightlife.
Come to Georgia and experience first-hand our historic charm and hospitality.
Please email your cover letter and resume in Microsoft Word format to: firstname.lastname@example.org
To ensure proper routing/handling of your credentials, copy/paste or type the following title in the subject line of your email: Regional Compliance Officer If you are currently employed by DBHDD, please include "Internal Employee" in the subject line as well.
You may be subject to a Drug Screen. You may be required to submit fingerprints to check for the existence of Criminal History Record Information through the Georgia Bureau of Investigation and the Federal Bureau of Investigation. You do have the right to challenge the contents of any Criminal History that is located, should you choose to do so.
The Georgia Department of Behavioral Health and Developmental Disabilities provides services to ensure the health and welfare of Georgians. As an employee of DBHDD, in the event of an identified emergency you may be required, as a term and condition of employment, to assist in meeting the emergency responsibilities of the department.