Policy & Compliance Specialist

Job Summary

Under the direction of the Quality, Risk and Compliance Director, the Policy & Compliance Specialist assist with oversight of Pathway’s internal and regulatory compliance program. This role assists the Director in developing, implementing, and maintaining policies and procedures to ensure the agency adheres to the requirements of all applicable laws and regulations, industry standards, and risk management practices. This role supports the Quality, Risk and Compliance Director and organizational leadership including finance, operations, program and technology leadership in the evaluation and development of effective internal controls, monitoring, testing, program governance, and process improvements.

Essential Duties:

• Assists the Director with staying abreast of federal and state regulatory changes and creating new or updating existing policies, procedures, and handbooks to ensure compliance.  
• Assists the Director in the development, administration and analysis of the agency’s compliance efforts, including those pertaining to agency policies, procedures, training, programs and other resources to meet regulatory compliance across a broad spectrum.
• Assists the Director in assessing, developing and providing training related to risk and compliance activities including HIPAA/security of information, fraud/waste/abuse and ethics, etc. 
• Must maintain current knowledge of and be able to interpret applicable federal and state laws, pending legislation, accreditation standards, monitor advancements in information privacy, security, and compliance technologies to determine the level and need for agency adaptation, including creating and updating agency policies and procedures and other applicable documents.
• Assists the Director in the evaluation of and development and implementation of Compliance and Risk Prevention and Management strategies to include policies, procedures, including legal and regulatory compliance, critical incident review, client grievance review and internal investigations to include reporting to program leadership, the Executive Leadership Team and Board of Directors.
• Interprets and analyzes data and provides reports to evaluate effectiveness of strategies, policies, procedures, and agency practices and for continual performance and quality improvement.
• Assists the HIPAA Privacy Officer (Director) as it relates to the implementation, maintenance, and monitoring of privacy policies and procedures in coordination with leadership and legal counsel.
• Coordinates with information management and information technology staff to ensure the security of information, effective data collection, storage, and the creation of internal controls and reports to optimize efficiency and quality of data being collected.
• Collaborates with leaders to prepare for and respond to audits, reviews, performance evaluations, government investigations, and queries.
• Assists the Director with activities for accreditation and on-going maintenance of accreditation. 

Supervisor:                            Quality, Risk and Compliance Director

Supervises:                           N/A

Work Environment:              Office or remote

Work Hours:                          Forty hours per week is expected. Work hours set by the employee and Director.

Classification:                       Exempt

Physical Demands

The employee should be able to perform, with or without reasonable accommodation, the physical and mental requirements of this job, which may include the following: seeing, hearing, speaking, and writing clearly.  The candidate will use the computer for long hours. Occasionally reaching with hands and arms, stooping, kneeling, crouching, crawling, frequent sitting, standing and walking, may be required for long periods of time and may involve climbing stairs. Additional physical requirements may include frequent lifting and or moving up to 25 pounds.

Education & Experience

• Bachelor’s degree from an accredited college or university required. Master’s degree from an accredited college or university in social work or another human services field preferred.
• Minimum three years of experience in managing risk and compliance activities and implementing comprehensive risk prevention and compliance program strategies.

Knowledge, Skills, & Abilities

• Thorough working knowledge of child welfare, clinical practices, and managed care/Medicaid.
• Must have strong regulatory interpretation and technical writing skills which will be required to assist with creating or updating policies, handbooks, etc., to ensure organizational compliance with regulatory requirements
• Ability to support the organization's culture, growth, and success through communication, accountability, and positivity.
• Ability to analyze, organize, and present data and research findings.
• Ability to communicate effectively, orally and written.
• Good clinical, interpersonal, and organizational skills.
• Ability to work efficiently and effectively both individually and as part of a team.
• Advanced level of PC skills.

Additional Requirements

• Proof of valid Texas Driver's License (Type C).
• Access to reliable transportation.
• Proof of valid/current auto insurance.
• Cleared motor vehicle driving record.
• Three employment references.
• Cleared criminal background check and signed statement regarding felony indictments/convictions.
• Cleared pre-employment drug screen.
• Working cellular telephone.
• Writing sample that demonstrates the skills necessary to perform the required duties.