Job Information
Burrell Behavioral Health Director of Compliance Risk Managment in Springfield, Missouri
Job Description:
Job Title: Director of Compliance Risk ManagementLocation: Springfield, MODepartment: Compliance and IntegrityEmployment Type: Full-timeShift: Monday - Friday 8:00 A.M. - 5:00 P.M
Job Summary:
The Director of compliance Risk Management plays a vital role in ensuring the integrity of healthcare services provided to our community. This position strategically identifies and mitigates potential risks, conducts comprehensive audits, and oversees compliance efforts to maintain ethical billing practices and regulatory adherence. By joining our team, you'll contribute to upholding the highest standards of care and foster trust in the healthcare system.
As the Director of Compliance Risk Management, you'll be responsible for conducting routine compliance risk assessments, developing and implementing internal audit work plans, analyzing audit reports, and overseeing audit coordination. You'll investigate suspect billing practices, analyze claims data for potential fraud, waste, and abuse patterns, and provide guidance on coding, billing, and documentation requirements. Additionally, you'll supervise and train the audit team, prepare and present audit activity reports, and ensure the confidentiality of business information.
The Director of Compliance Risk Management position offers...
All-Inclusive Employee Benefits Package - A robust employee benefits package encompassing health, dental, vision, retirement, disability, life insurance, wellness program, and more
Telemedicine -- 24/7 phone, web, or mobile app medical, behavioral health, & dermatology visits with copays as low as $15 if enrolled in health benefits
Employee Assistance Program -- 24/7 counseling services, legal assistance, & financial consultation for you and your household at no cost
Paid Time Off - 29 days per year including vacation & holiday pay
Premier Training - Encompassing initial immersive onboarding, continuous skill enhancement, comprehensive curricula, and a supportive learning atmosphere.
Professional Growth Pathways - Abundant prospects for upward mobility and advancement, fostered by a promotion-from-within philosophy
Workplace Culture - An environment cultivating employee wellbeing, valuing each individual's humanity, and actively promoting healthy, joyful workforce engagement
Key Responsibilities:
Conduct routine Compliance Risk Assessments with Brightli System Members
Develop and implement internal audit work plans based on Compliance Risk Assessments and ongoing billing/documentation trends
Update internal audit work plans regularly based on Compliance Risk Assessments and ongoing billing/documentation trends
Receive, analyze, and maintain internal and external audit reports
Oversee the development and maintenance of audit tools
Administer internal auditing programs per best practices and internal work plans
Supervise coordination of internal and external audit activities
Track development and implementation of corrective action plans from audits
Conduct and direct investigations into suspect billing for Federal health care program overpayments
Analyze claims data for potential fraud, waste, and abuse patterns
Prepare and present audit activity reports to Compliance Committees and People Leaders
Provide guidance on coding, billing practices and documentation requirements
Supervise Lead Compliance Audit Coordinator and train Audit Team Members
Maintain work papers, files, and documentation per regulatory requirements
Ensure confidentiality of business information, including protected Health Information (PHI), as per HIPAA and company policy
Education and/or Experience Qualifications:
Bachelor's degree from an accredited college or university in Health Information Management, Healthcare Compliance or related field required
At least one of the following credentials (RHIA, RHIT, CHC), required
Three to five years' experience in healthcare related compliance, auditing or health information management
Required License/Certification (one of the following):
RHIA (Registered Health Information Administrator)
RHIT (Registered Health Information Technician)
CHC (Certified in Healthcare Compliance)
Additional Qualifications:
High energy, motivated personality who enjoys researching and learning new things
Ability to develop a vision and strategically work toward the vision
Ability to develop and maintain timelines
Ability to organize people and projects
High level communication skills
Able to develop written reports and communicate results in a positive and collaborative way both verbally and in writing
Can work well with others and build relationships of trust with management
Ability to exercise independent decision making
Positive team player
Supervisory Requirements:
Communicate the strategic direction of the organization and encourage participation by all employees
Provide leadership and guidance to all aspects of the department
Take an active role in monitoring the identification, development, and execution of strategic objectives
Involve, as appropriate, all employees in order to achieve goals
Effectively communicate to employees any changes and newsworthy events within the department or company
Handle difficult employee situations directly, using appropriate discretion and Human Resource advice to show respect for the individual
Champion change and effectively manage the implementation of new ideas
Reinforces team approach throughout functions; support and solicit input from team members at all levels with the company
Maintains confidentiality of business information, including Protected Health Information (PHI), as required by HIPAA and company policy
Employment Requirements:
Successful completion of background check including criminal record, driving record, abuse/neglect
Completion of New Hire Orientation at the beginning of employment
All training requirements including Relias at the beginning of employment and annually thereafter
Current driver's license, acceptable driving record and current auto insurance
Physical Requirements:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions
While performing the duties of this job, the associate is frequently required to sit and stand for extended periods (2-4 hours); walking may be required for short periods when conducting field-based activities
They must frequently use hands and fingers to write, type, operate a mouse, file documents, and otherwise handle documents
They must occasionally lift and/or move up to 50 pounds
We are an Equal Opportunity and Affirmative Action Employer, and encourage applications from all qualified individuals without regard to race, color, religion, sex, gender identity, gender expression, sexual orientation, national origin, age, marital status, disability or veteran status, or to other non-work related factors.
Preferred Family Healthcare is a Smoke and Tobacco Free Workplace.
About Brightli
Brightli is on a mission: A mission to improve client care, reduce the financial burden of community mental health centers by sharing resources, a mission to have a larger voice in advocacy to increase access to mental health and substance use care in our communities, and a mission to evolve the behavioral health industry to better meet the needs of our clients. We are doing this by forming a new behavioral health organization under new model. Under one parent company, multiple organizations are able to collaborate, share resources and system supports, increase recruiting and retention efforts, increase access to specialized care, and meet the growing demand for behavioral and addiction recovery care.
Brightli’s top-line subsidiaries include Burrell Behavioral Health (Burrell), Preferred Family Healthcare (PFH), and Southeast Missouri Behavioral Health (SEMO). While these organizations operate independently and are governed by separate board of directors, their operations and services benefit from this model. Alone, organizations may be able to navigate the current tumultuous healthcare environment, but we believe that together we can do so much more than survive. Our communities need us now more than ever, and by working together we are ready to answer their call for years to come.
Brightli Snapshot
200 locations
4 states
19 subsidiaries and/or affiliates
5k+ employees