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Responsibilities

Under the supervision of the Chief Compliance Officer, the Vice President of Compliance is responsible for developing and maintaining a comprehensive compliance, audit management, and facility oversight plan for InnovAge PACE/LIFE Programs. The Vice President of Compliance leads the direction and management of compliance oversight including supervision of the audit management program and resources; supervision of the facility oversight program; development of policy and procedure management; implementation of compliance education and training, as well as initiation of compliance projects to ensure organizational integrity. The position supports the Chief Compliance Officer in fulfilling her/his oversight role by providing management, oversight, and assessment of the organization's clinical and operational practices compared to regulatory requirements. The Vice President of Clinical Compliance will be tasked with implementing corrective action plans (internal and external) to address risk areas identified.

Essential Functions and Work Responsibilities

Functional Category: Risk Management and Compliance Auditing and Oversight

Estimated Percent of time Spent – 100%

• Perform and manage audits of documentation, functions, and departments in all business lines to ensure adherence to regulatory guidance.

• Manage Regional Directors of Clinical Compliance, Audit Management; Director of Facility Oversight; Compliance Coordinator, and Augmented Audit staff as needed in alignment with the goals of the Compliance Department.

• Promote a culture of compliance across the enterprise by serving as a compliance expert resource.

• Oversee the organizational practices to assess compliance with regulations and government agencies regarding service documentation.

• Increase communications with providers, operations, and nursing to establish working relationships which encourage consistency with compliance practices and expectations.

• Lead discussions and develop projects to identify and mitigate compliance issues in practice areas.

• Ensure policies and procedures in the practice setting to ensure adherence to applicable laws, rules, and regulations.

• Participate in leadership meetings to promote compliance initiatives and respond to concerns raised.

• Promptly investigate reports of non-compliance or suspected violations of non-compliance and implement corrective actions as deemed appropriate.

• Assist with audit & compliance related special projects as requested.

• Develop audit processes and maintain audit tools for use in all lines of business.

• Collaborate with members of Corporate Compliance, as part of the compliance team, to share expertise and experience in building a culture of compliance across the organization.

• Remain current on federal and state regulations related to physician services and practices.

• Provide strong, clear verbal and written communication with an ability to convey complex ideas and information.

• Translate complex clinical mandates into operational workflows.

• Assists and leads compliance initiatives for State Ready Reviews (SRR) for new Centers.

Travel Requirements

Travel - estimated 40%

• Travel between InnovAge worksites

• Overnight travel out of state

Relocation

• N/A

Qualifications

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions

Job Requirements

• Resourceful, highly organized self-starter with a bias towards action and efficiency

• Trusted, team player looking to drive success in a fast-paced environment

• Solid computer skills, specifically using MS Word, Outlook, and Excel

• Excellent oral, written, and interpersonal communication skills, facilitation skills

• Data analysis and interpretation aptitude

• Innovative problem-solving skills

• Excellent presentation skills for both clinical and non-clinical audiences

Work Experience:

• Eight to Ten years of experience across clinical compliance and/or regulatory functions in a healthcare delivery or healthcare environment

• Three to five years of experience managing enterprise level employees and/or teams

• Three to five years of experience conducting investigations to determine regulatory compliance

• Experience with integration of clinical, operations, and financial data; development of audit, utilization and performance reporting tools; and communication of performance data to healthcare stakeholders

• Experience with telecommuting and remote monitoring

Knowledge, Skills & Abilities:

• Familiar with navigating the electronic medical record (EMR) systems to complete reviews

• Strong analytical skills

• Works well with numbers, using basic math skills

• Formidable team player

• Ability to work with multiple and diverse clients and projects

• Ability to work with minimal supervision

Licensure, Certification, Registration or Designation

• Must have a state-issued driver’s license, personal transportation, safe driving record, and auto insurance as required by law

• Bachelor of Science / related field, or equivalent years of experience

• Nursing License, RN, preferred, or clinical equivalent

• Certification in Healthcare Compliance (CHC) preferred