Healthcare Compliance Specialist II

Title: Healthcare Compliance Specialist II

State Role Title:Health Care Compliance Spec II

Hiring Range: $75000.00 - $90000.00

Pay Band: 5

Agency: Office of State Inspector Gen

Location:Richmond City

Agency Website: Type: General Public - G

Job Duties

The Office of the State Inspector General (OSIG) is currently recruiting for and seeking a qualified individual for the position of Healthcare Compliance Specialist II. The Office of the State Inspector General on behalf of the citizens of the Commonwealth serves as a catalyst for positive change by: facilitating good stewardship of resources; deterring fraud waste abuse and corruption; advocating efficiency and effectiveness; and promoting integrity and ethical addition OSIG provides an independent system of accountability regarding the quality of services provided by facilities operated by the Department of Behavioral Health and Developmental Services (DBHDS) DBHDS licensed providers Community Services Boards (CSBs) and others in order to improve quality of services and protect the health and welfare of individuals served. The primary duty of this position is to support the duties of the State Inspector General in fostering and promoting public accountability through monitoring and quality reviews. The person in this position actively engages in a number of activities designed to evaluate the quality and effectiveness of the service delivery system operated/funded/licensed by the Department of Behavioral Health and Developmental Services (DBHDS) in order to prevent problems abuses and deficiencies in and improve the effectiveness of DBHDS licensed and operated programs and services and other programs defined by the Code of Virginia. Activities include but are not limited to complaint intake and response projects reviews and performing other quality management performance improvement and risk reduction activities. Writing high quality professional and comprehensive reports identifying opportunities for improvement and making specific recommendations designed to address root causes of those findings. Additional objectives of these activities are to: 1) Gather and assess information and data identify any violations of rules and regulations policies and procedures standard practices or other problems/abuses/deficiencies that negatively impact programs operated/ licensed/funded by DBHDS and other programs defined by the Code of Virginia as well as the individuals served; 2) Gather sufficient factual evidence for use in determining whether operational programmatic personnel or administrative actions are recommended in order to diminish risk factors and improve quality of services and 3) Ensure that the findings of all reviews are appropriately communicated to management through briefings and reports so that findings and recommendations are brought to the attention of appropriate officials for corrective actions.

Minimum Qualifications

Considerable experience and knowledge of behavioral health substance use and/or developmental services programs operated licensed or funded by the DBHDS or by other providers as defined in the Code of Virginia. Working knowledge of federal and state regulations pertaining to the behavioral health and developmental services system. Demonstrated analytical critical thinking and problem-solving skills. Demonstrated ability to review a function area or situation of a highly complex nature and formulate applicable audit review and/or inspection procedures. Excellent ability to communicate effectively both orally and in writing to all levels of staff and management. Experience writing professional reports. Experience and skill in inspection instrument construction data collection and analysis. Must possess good communication and assessment skills. Strong computer skills (Windows Word Excel Pentana email) are a must. High school graduate or equivalent.

Additional Considerations

Current licensure/certification (RN PhD/PsyD PharmD CPHQ CPHRM CHCO). Preferred experience facilitating (serving as lead) in Joint Commission Centers for Medicare & Medicaid Services (CMS) and or CARF surveys.

Special Instructions

You will be provided a confirmation of receipt when your application and/or résumé is submitted successfully. Please refer to Your Application in your account to check the status of your application for this position.

State employees who have been affected by Policy 1.3 Layoff and possess a valid Interagency Placement Screening Form (Yellow Card) or a Preferential Hiring Form (Blue Card) must submit the card BEFORE the closing date for this position. The card may be scanned and attached to the application or faxed to . Please include your name and the position number of the fax cover sheet. A criminal background investigation prior to employment is required for the successful candidate. Drug screening will be required upon employment.
Reasonable accommodations are available to individuals with disabilities during the application and/or interview processes per the Americans with Disabilities Act. AMERICORPS PEACE CORPS AND OTHER NATIONAL SERVICE ALUMNI ARE ENCOURAGED TO APPLY. Please call for assistance.

The Office of the State Inspector General is dedicated to recruiting supporting and maintaining a competent and diverse work force.
Equal Opportunity Employer
Office of the State Inspector General
P.O. Box 1151
Richmond Virginia 23218

Contact Information

Name: Derek T. Mountford PHR SHRM-CP

Phone:

Email:

In support of the Commonwealths commitment to inclusion we are encouraging individuals with disabilities to apply through the Commonwealth Alternative Hiring Process. To be considered for this opportunity applicants will need to provide their AHP Letter (formerly COD) provided by the Department for Aging & Rehabilitative Services (DARS) or the Department for the Blind & Vision Impaired (DBVI). Service-Connected Veterans are encouraged to answer Veteran status questions and submit their disability documentation if applicable to DARS/DBVI to get their AHP Letter. Requesting an AHP Letter can be found at AHP Letter or by calling DARS at .

Note: Applicants who received a Certificate of Disability from DARS or DBVI dated between April 1 2022- February 29 2024 can still use that COD as applicable documentation for the Alternative Hiring Process.