Date Posted:

November 10, 2014

Salary:

$43.13 – $52.43 Hourly

Description:

The Sonoma County Department of Health Services (DHS) seeks a knowledgeable and experienced Compliance and Departmental Risk Manager.

Reporting to the Assistant Director of Health Services, the Compliance and Departmental Risk Manager leads a team that is responsible for carrying out compliance, privacy, and department-wide risk functions. This position oversees the Department’s federal and state required healthcare compliance program, manages the Department Compliance Program, and ensures adherence to laws and regulations such as the Health Insurance Portability and Accountability Act (HIPAA) privacy and security rules. The position conducts related staff training and provides guidance on confidentiality laws to all DHS direct service programs.

The position is responsible for compliance with the State Mental Health Plan contract, including but not limited to, oversight of: claiming of services to Medi-Cal, Medicare, and other third party payers; the procedures for completing the annual cost report and implementing Mental Health Medi-Cal Administrative Activities (MH-MAA); provider credentialing; and required audits of internal and contracted programs that provide Medi-Cal covered services to ensure compliance with Title 9. The incumbent is also responsible for ongoing review of State Department of Health Care Services Notices and any legislation that impacts compliance with the County’s obligations under the State Mental Health Plan contract, including the expansion of services required by the Affordable Care Act and obligations to integrate behavioral health services and primary care.

The Compliance and Departmental Risk Manager is the department liaison with County Counsel and outside counsel. Responsibilities include presenting issues that require legal opinions, ensuring that the Department response to the issue is consistent with counsel direction, and collecting and providing data and information required for cases in litigation.


The Ideal Candidate

The Department of Health Services is seeking a candidate that has a proven track record of leadership and fits the following profile:•The ability to manage a comprehensive health care compliance program.
•Solid knowledge of State and Federal health care laws and regulations, including State Mental Health Plan regulations and the Mental Health Services Act.
•Comprehensive knowledge of State and Federal laws regarding claiming of health care services.
•The ability to develop and conduct staff training programs.
•Excellent supervisory, interpersonal, and communication skills.
•The ability to develop an auditing program to assess compliance with local, state, and federal laws, and to oversee the audit process.
•Confident, inspiring leader and team motivator, with an effective management style.
•Commitment to improving organizational effectiveness and implementation of ongoing quality improvement initiatives.

 

Qualifications:

likely provide for the possession of stated knowledge and abilities.

Education: Normally, significant academic course work in business/public administration, health administration, systems analysis, finance, economics, or a closely related field. A Bachelor’s or Master’s degree in any of the above fields is highly desired.

Experience: Normally, three years of professional level experience in a health care setting that included significant responsibility in any of the following areas: regulatory compliance and privacy, quality assurance and control, legal analysis of health care administration, and/or fiscal operations; including at least one year of supervisory experience.

License: Possession of a valid driver’s license at the appropriate level including special endorsements, as required by the State of California, may be required depending upon assignment to perform the essential job functions of the position.

Certificate: Must possess or obtain within eighteen (18) months of appointment a healthcare compliance certificate from a certified association.

Considerable knowledge of: healthcare operations; federal and state laws and regulations pertaining to health care providers including, but not limited to: Medicare and Medi-Cal, Sarbanes-Oxley requirements; health information privacy laws, including those related to access, release of information, and release control technologies (Health Insurance Portability and Accountability Act of 1996 (as amended)); Office of Inspector General’s compliance program, government compliance; regulatory audits; electronic security issues and technologies.

Knowledge of: principles and practices of general management and public administration, program management, and supervision; quality improvement principles, principles and practices of risk management; contract administration; California Public Records Act; methods of legal and factual research; quality improvement principles; techniques of systems analysis; principles and practices of project planning, monitoring, and evaluation; effective interviewing and investigation techniques; English grammar, usage, and syntax; computer software including word processing, spreadsheet, and database programs; health care and social service programs provided by the County.

Ability to: research, understand, interpret, and apply rules, regulations, and ordinances and federal, state, and local legislation pertaining to health care and health information privacy; analyze problems and/or complex data, draw conclusions, explain implications, and make sound recommendations; plan, organize, and direct comprehensive programs including developing and implementing short and long-range project goals and objectives; plan organize, delegate, and prioritize work of self and others in order to meet deadlines; establish performance standards and evaluate performance; communicate effectively both verbally and in writing, including the ability to draft complex documents and reports; effectively explain rules, regulations, and procedures; gain cooperation and compliance from staff; represent the County in an effective and professional manner and establish and maintain effective working relationships with the public, other departments and agencies, boards and commissions, public officials, community groups, and others contacted in the course of work; interview effectively; maintain confidentiality.

 

How to Apply:

If you are interested in this outstanding opportunity, please submit an online job application and responses to the supplemental questions, which articulate your experience, responsibilities, and pertinent accomplishments by Tuesday, November 25, 2014.

Apply at www.yourpath2sonomacounty.org. 

Filing Deadline:

11/27/2014