Director of Compliance Audit

Director of Compliance Audit Centria Healthcare - 3.1 Farmington Hills, MI Job Details $90 an hour 3 hours ago Qualifications Computer operation Google Workspace Staff supervision Customer relationship building Customer service Employee relationship building Bachelor's degree Health insurance knowledge Desktop applications Data interpretation Productivity software General management Senior leadership

Full Job Description Position Overview:

The Director of Compliance Audit is an integral team member at Centria both inside and outside of the Compliance Department. This role requires an understanding of Centria's multifaceted operations and various shared service departments at the Resource Center. Building strong relationships and trusted collaboration with Executive Leadership and Centria Department Heads is a critical component of success in this role. Under the direction of the Chief Compliance Officer, the Director of Compliance Audit has primary responsibility for the following elements of

Centria's Compliance Program:

Monitoring all incoming payor audit requests, completing systematic audit tracking processes, conducting pre-audit assessments of potential deficiencies, coordinating audit responses, and providing oversight of the remediation of deficiencies identified by external auditors. Overseeing the design, planning, and execution of all internal compliance audit initiatives across the company. These initiatives will include but are not limited to, validation audits on claims, accurate coding of health care services rendered, provision of services specific to federal/state law and contractual requirements, and compliance with Centria policies and procedures and internal controls. Developing an Internal Audit Plan consistent with the annual Compliance Work Plan.

Responsibilities:

The below reflects the essential functions considered necessary for this role and shall not be construed as a detailed description of all work requirements inherent in the job or assigned by supervisory personnel. This job description is used as a guide only and not inclusive of all responsibilities and job duties. Serve as the primary contact for payor audits and direct Centria's external audit preparation, tracking, response and remediation processes. Work collaboratively with operations, clinical, and quality assurance team members to address external Corrective Action Plans (CAPs) and to monitor necessary action items for completion. Perform compliance audits of operational adherence to payor contract or CAP requirements. Develop and maintain internal audit standards and protocols. Develop and implement internal audit training on standards and protocols for internal audit staff. Oversee the design, planning, and execution of internal audits completed by the Compliance Department. Meet with stakeholders to report findings and advise on the Plan of Correction. Monitor the progress and completion of all Plans of Correction that result from audit findings. Monitor and control Internal Audit expenses throughout the year for the department's budget. Other duties as assigned by the Chief Compliance Officer. Compliance with Centria's Code of Conduct, policies and procedures, and Federal and State laws. Responsibility to report violations of Company policies or the Code of Conduct.

This role is responsible for:

Leading and maintaining staff by interviewing, selecting, orienting, and training new team members; Ensuring the daily functions of the department are completed by communicating job expectations, planning, monitoring, and appraising job results; Managing, coaching, and developing a high performing team that meets agreed objectives and which delivers best practice results, added value, and continuous improvements; Consistently promoting high standards through personal example and roll out through the team so that each member of the team understands the standards and behaviors expected of them.

Required Qualifications, Skills, and Knowledge:

Bachelor's degree required Master's degree preferred National Certification in Auditing or Healthcare Compliance, preferred Minimum of 6 years' experience in the healthcare field with expertise in compliance auditing Management or leadership experience Excellent customer service and relationship skills Basic computer skills Working knowledge of laptop/desktop PC Proficiency in Microsoft Suite Proficiency in G Suite Ability to follow written instructions Ability to use computers and computer/software programs Ability to communicate expressively and receptively Excellent communication skills, both written and verbal; Data-driven with an aptitude for interpreting results and firm adherence to process; Comprehensive understanding of payor requirements and proficiency in navigating CareConnect; Track record of success in payor audit responses; Knowledge of ABA requirements for nationwide payors; Strong understanding of Centria operational processes with the ability to work collaboratively with other departments in collecting documentation; Knowledge of computer systems related to compliance, operational, and HR functions; Knowledge of audit and compliance process; Ability to organize, prioritize and handle multiple tasks, adhere to established deadlines, and produce work that consistently meets or exceeds team benchmarks; Proven adaptability with a willingness to work both collaboratively and individually to achieve desired business outcomes; Excellent interpersonal and listening skills; Demonstrated strong work ethic with attention to detail, accuracy, and quality; Established track record of generating error-free work.

Pay:

$90,00$120,000 plus bonus

Working Conditions:

This position utilizes a hybrid work schedule requiring some office hours at the Resource Center. Centria's standard office hours are Monday through Friday from 8:30 AM - 6:00 PM. Additional time or occasional shifts in schedule may be required to complete the above work or meet company objectives.

Physical Requirements:

While performing the duties of this job, physical requirements such as bending, reaching and lifting of up to 50 pounds may be required. This role will require sitting a majority of the day as well as walking as standing when needed. This role will require close visual activity on multiple computer screens or monitors and the ability to analyze data and figures on a screen. We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, Veteran status, or disability status. This job description is not intended to be an exhaustive list of qualifications, skills, efforts, duties, responsibilities, or working conditions associated with the position. Centria reserves the right to amend this job description at any time, with or without written notice.