Compliance Manager

About Piedmont Health Services

Piedmont Health Services, Inc. (PHS) is a 501(c)(3) nonprofit and Federally Qualified Health Center (FQHC) in North Carolina. Dedicated to delivering top-tier, accessible, and inclusive primary healthcare, PHS has proudly served for 54 years and remains the largest community health center in central NC. Operating 10 Community Health Centers, two PACE (Program of All-Inclusive Care for the Elderly) Senior Care facilities, and 2 Mobile Health Units, PHS extends its services to residents across five counties, including Alamance, Caswell, Chatham, Orange, and Lee.

What is PACE?

At Piedmont Health Senior Care, we are dedicated to enhancing the lives of seniors in our community through our Program of All-inclusive Care for the Elderly (PACE). We help seniors maintain their independence and continue living at home for as long as possible. We achieve this by offering comprehensive, personalized healthcare and related services, all tailored to the unique needs and aspirations of each senior we serve.

Our approach is unlike any other healthcare plan! PACE emphasizes a participant-centered strategy, focusing on providing the right care and services that best support each participant's unique needs and goals. We integrate and coordinate all aspects of care, leveraging a team of dedicated doctors, nurses, therapists, dieticians, and other specialized professionals who work together as a care team to manage and address the complete health needs of each.

Job Title - Compliance Manager

Department - Quality and Compliance

Reports to - PACE Executive Director

Benefits -

• Medical, Dental, Vision, Life Insurance (Short & Long Term Disability)
• 403(b) Plan
• Paid Holidays
• CME (Continuing Medical Education)
  
  

About Position: The primary responsibility of the Compliance Manager is to work collaboratively with the PACE Executive Director and other team members on effective development, revision, and implementation of the PACE compliance plan. The incumbent will work with PACE management to ensure day-to-day compliance with the PACE regulations by the employees at the PACE sites. The incumbent will work closely with the Quality Manager to ensure that required data is collected, organized, reported, is accurate, and submitted; on audit preparedness, data submission for audits, and follow up with auditors; and on an on-going basis in joint support of these two critical areas of the PACE program, quality and compliance. The incumbent serves as a subject matter expert for PACE regulations, and as such provides necessary compliance guidance to the interdisciplinary teams. The incumbent identifies gaps in compliance and develops a root cause analysis and corrective action plan to address these gaps. The incumbent participates on the PACE leadership team. Implementation of Piedmont Senior Care compliance plan including Part D and health plan requirements. Other duties as assigned.

• Work Location: PACE Pittsboro
  
  

163 Chatham Business Dr, Pittsboro, NC 27312

• Schedule: Monday - Friday 8:00 am - 5:00 pm
• Travel: As needed
  
  

Duties/ Responsibilities -

• Works collaboratively with the PACE Executive Director on the development, revision, and implementation of an effective PACE compliance plan.
• As a subject matter expert for PACE regulatory requirements, serves as a main resource for communication, education, and interpretation of the regulations for PACE team members.
• Oversees day-to-day compliance of all personnel with PACE regulations.
• Collaborates with PACE Quality Manager in mutual support of an effective quality and compliance program.
• Develops and implements processes to ensure regulatory compliance.
• Generate letters for decisions on requests for service and resolutions for grievances, notify participants or caregivers of outcomes and rights, and document communication in the chart for requests for service.
• Serves as a point person with CMS and NC Medicaid regulators in support of the PACE compliance program.
• Monitors compliance on an on-going basis, addressing areas of non-compliance or potential non-compliance.
• Collaborates with PACE leadership team on meeting strategic compliance and quality goals.
• Performs data collection, management and reporting and provides to pertinent regulators and stakeholders.
• Ensures data accuracy.
• Determine the need for root cause analysis (RCA) and correction action plans (CAPs) in incident reports and other areas of compliance, and, in collaboration with the Quality Manager, coordinates follow up with relevant team members as indicated. .
• Maintain care plan schedules and ensure steps in the care planning process are completed.
• Supports PACE Quality discipline-level initiatives through data management and process improvement.
• Gather data for PACE Quarterly Dashboard in joint compilation with the Quality Manager.
• Participates for compliance matters on the Quality Committee and sub-committees as assigned.
• Gather data to report to Quality Manager for submission to Health Plan Management System (HPMS) and DataPACE3, the national PACE benchmarking database.
• Collects and submits reports to the Public Consulting Group (PCG) database.
• Perform various administrative and general compliance duties as assigned.
  
  

Qualifications -

Education: Bachelor’s degree required.

Required: Two (2) years’ experience in healthcare; 1-year experience in corporate compliance, quality or risk management experience in a healthcare setting; or a combination of experience and education.

Requires frequent lifting and carrying items weighing up to 40 pounds unassisted. Requires frequent bending, reaching, and repetitive hand movements, standing, walking, squatting and sitting, with some heavy lifting, pushing and pulling exerted regularly throughout a regular work shift. Requires exposure to communicable diseases and/or bodily fluids.

Preferred: Demonstrated experience working independently. One year of experience with the frail or elderly, preferred.

Ability to use computerized tracking tools; Experience with data collection, analysis and reporting as it relates to clinical issues, including medical charts. audits and clinical analysis. Experience with EMR. Proficient in Excel.

Current/valid License

Immunizations: All PHS required immunizations

Pay Range - $76,424 - $88,596

EEO Statement

Piedmont Health Services, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to sex, sex stereotyping, pregnancy (including pregnancy, childbirth, and medical conditions related to pregnancy, childbirth, or breastfeeding), race, color, religion, ancestry or national origin, age, disability status, medical condition, marital status, sexual orientation, gender, gender identity, gender expression, transgender status, protected military or veteran status, citizenship status, genetic information, or any other characteristic protected by federal, state, or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.

DEI Statement

Piedmont Health Services, Inc. (PHS) endeavors to maintain an inclusive workplace, one that is reflective of the patient population that we serve and the individuals whom we employ. We strive to incorporate inclusiveness throughout our work culture, including the way that we recruit, support, and retain employees. We believe that having employees from diverse backgrounds, cultures, and experiences is an asset. It helps us to view the world through different lenses embodying the perspectives, opinions, approaches, and values that our employees bring to work daily. In fact, inclusion is woven into the very fabric of our work life, which allows our employees to perform at their highest possible potential.