Health Care Compliance Specialist II

Title: Health Care Compliance Specialist II

State Role Title:49172

Hiring Range: Negotiable based on relevant years of experience

Pay Band: 5

Agency: Dept Behavioral Health/Develop

Location:Southern Va Mental Health Inst

Agency Website: Type: General Public - G

Job Duties

To assist and oversee in the planning development implementation monitoring education and training to promote a Medicare Voluntary Compliance Program and related Risk Management and Quality Improvement programs. Works with Utilization Management Coordinator to ensure compliance with applicable CMS Conditions of Participation.

Minimum Qualifications

Previous experience in a healthcare setting required.

Experience in the compliance profession to include investigations and health information management required.

Clinical/direct care delivery experience in an inpatient psychiatric setting required.

This position will also include:
Knowledge of 1) Medicaid and Medicare administration policies and practices 2) Clinical Documentation 3) Administration and training principles and practices 4) Applicable Federal State and Departmental laws regulations and policies Skills include: 1) Problem Identification 2) Information Gathering 3) Organization 4) Critical Thinking 5) Interpersonal Diplomacy/Professionalism. Knowledge of inpatient psychiatric treatment and documentation required to include interdisciplinary treatment planning discharge planning and psychosocial rehabilitation. Functionally adept at working within EHR system Millennium. Ability to communicate effectively both orally and in writing with clinicians administrators and Individuals. Ability to assist with Utilization management principles third party reimbursement systems and associated legal/regulatory requirements. Basic computer skills in typing Microsoft Word and Microsoft Excel. Ability to write policies procedures and instructional tools; design forms; and produce memorandums agendas and minutes. Ability to work independently to include organization prioritization and maintain timelines of multiple tasks/projects.

Additional Considerations

Experience assisting with regulatory surveys i.e. Joint Commission CMS VDH OSIG.

One of the following education training and/or experience is desirable:
Licensure as a Registered Nurse
Bachelor of Social Work

Veterans and people with National Service.

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.

Applicants must list all relevant experience that you wish to be considered for this position. Applicants will be provided confirmation of receipt when your application and/or resume is submitted. Please refer to Your Application in your account to check the status of your application for this position.

A successful fingerprint-based criminal history check drug screen and reference checks are required for the selected candidate for this position. Under Virginia Code 37.2-314 and 37.2-408.1 the Department of Behavioral Health and Developmental Services is prohibited from employing or using as volunteers persons who have been convicted of specific barrier crimes or persons who may be the subject of pending barrier charges.

Employees may be required to disclose immunization status for purposes of infection prevention and/or management of outbreaks. Upon acceptance of a job offer new recruits will be asked to disclose their vaccination status (and for those fully vaccinated proof of vaccination) during the pre-employment process. If you have any questions contact the Office of Human Resources.

Commonwealths Alternate Hiring Process: In support of the Commonwealths commitment to inclusion individuals with disabilities are encouraged to apply through the Commonwealth Alternative Hiring Process. To be considered for this opportunity applicants will need to provide their Certificate of Disability (COD) provided by a Certified Rehabilitation Counselor with the Department of Aging and Rehabilitative Services (DARS). Veterans are encouraged to answer Veteran status questions and submit their disability documentation if applicable to DARS to get their Certificate of Disability. To obtain a Certificate of Disability go to: or call DARS at . Reasonable accommodations are available to persons with disabilities during the application and/or interview process per the Americans with Disabilities Act. Contact Human Resources at for assistance.

DBHDS is an equal Opportunity Employer. Employment opportunities are open to all regardless of race sex color national origin religion sexual orientation gender identity age veteran status political affiliation genetics or disability. Minorities Individuals with Disabilities Veterans and people with National Service experience are encouraged to apply. EEO/AA/TTY.

SVMHI uses Form I-9 and E-Verify in the verification of eligibility for employment.

SVMHI is a smoke and vape-free facility in all buildings and outside facility grounds.

Contact Information

Name: Human Resources

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.