Director of Compliance and Lead Auditor Cambridge, MA, United States Job Description Schedule: Mon-Fri 9am-5pm Salary: $150,000 to $160,000 / year Working with and reporting to the Chief Legal and Compliance Officer, the Director of Compliance and Lead Auditor ensures the successful functioning of the agency’s compliance plan, including: monitoring and auditing the agency’s compliance with applicable state (both Massachusetts and Connecticut) and federal regulatory requirements, as well as state funder and third-party payor contracts, investigating allegations of non-compliance, creating and enforcing written policies, procedures and standards of conduct and creating and providing training to staff on compliance-related topics. Additionally, the Director of Compliance and Lead Auditor will conduct compliance risk assessments and develop responsive action plans to address identified concerns, including, where appropriate, developing multi-year plans. The Compliance Director and Lead Auditor will identify and inform the organization of relevant changes in federal, state, or local regulations which might impact operational or administrative processes and work with cross-division teams to implement regulatory changes as needed. As well as analyzing and synthesizing compliance-related data, including audit and monitoring results, for the agency’s Compliance Committee and Chief Legal and Compliance Officer. The Director of Compliance and Lead Auditor will also lead the audit team, including the Field Audit Manager and Field Auditor. The Director of Compliance and Lead Auditor also:
Remains familiar, and stays current, with applicable state and federal rules governing behavioral health providers and health and human service organizations, including regulations issued by the Centers for Medicare and Medicaid Services (CMS), MassHealth, the Massachusetts Department of Mental Health, the Massachusetts Department of Developmental Services, the Connecticut Department of Developmental Services and the Connecticut Department of Mental Health and Addiction Services.
Remains familiar, and stays current, with applicable state and federal fraud, waste and abuse laws.
Independently designs and conducts audits to ensure compliance with applicable requirements, including payor and funder billing and documentation requirements. Develops, issues, and tracks corrective actions plans to address adverse audit findings.
Develops and implements internal controls to improve compliance performance.
Creates and edits policies, procedures and standards of conduct to ensure compliance with applicable regulatory requirements.
Creates and provides training to staff on compliance-related matters, including billing requirements and fraud, waste and abuse laws.
Works with the Chief Legal and Compliance Officer and the Compliance Committee to develop and oversee the compliance plan.
Works with the Chief Legal and Compliance Officer and the Compliance Committee to conduct periodic compliance risk assessments and develop responsive action plans to address any identified concerns. Monitors and tracks progress of responsive action plans.
Works with the Chief Legal and Compliance Officer, and outside counsel when appropriate, to identify and evaluate potential compliance risks to the organization.
Serves as the agency’s liaison with outside regulators and payors and provides information and documents responsive to external requests.
Works with the Chief Legal and Compliance Officer to facilitate Compliance Committee meetings, including analyzing compliance-related data and creating related reports.
Works with cross-division teams to identify and respond to compliance-related issues, including creating and documenting internal processes and procedures and implementing new regulatory changes.
Ensures timely completion of assignments in an organized and efficient manner.
Establishes and maintains effective communication and interpersonal skills to contribute to a positive work environment.
Adheres to policies and procedures.
Performs other duties, as assigned.
Why? We are committed to you! We offer great training, great benefits, career growth and job security!
Medical, Dental and Vision Insurance for employees working 30 hours or more
15 days of Vacation, 12 Paid Holidays, 10 Sick Days and 3 Personal Days per year (for employees scheduled for 20 hours or more)
Education Assistance and Tuition Remission Programs as well as innovative Student Loan Payment Programs. Employment here counts toward your Public Student Loan Forgiveness eligibility
Professional Development programs including year-round online training courses and opportunities to earn CEUs
Retirement savings programs, including a fully funded, employer sponsored retirement plan and an employee funded 403 (b) plan
Company paid Life, Accidental Death & Dismemberment and Long-Term Disability Insurance
Voluntary Term, Whole Life, Accident and Critical Care Insurance
Flexible Spending Reimbursement Accounts (Health and Dependent care)
$500 — $1,000+ Employee Referral Bonuses with no annual cap!
Other generous benefits including discounted memberships, access to wellness programs and more!
Requirements
Bachelor’s degree in business or related field required. JD or other advanced degree a plus but not required
At least three to five years of relevant compliance experience
At least three to five years of internal audit experience
Knowledge of applicable federal and state regulations
Familiarity with applicable Connecticut regulations a plus but not required
Relevant experience working in a healthcare and/or health and human services environment a plus but not required
Must have strong attention to detail, excellent verbal and written communication skills
Must have strong analytical skills, strong organizational skills, including the ability to multi-task and prioritize assignments
Knowledge of auditing and monitoring processes and evaluation techniques
Must be proficient and knowledgeable personal computer applications, including Microsoft Excel and Word, and equipment
Knowledge of and ability to research federal and state regulations and payor specifications
Must have leadership skills and be able to work with a wide range of employees
ability to work in a professional and confidential capacity
Must have excellent project management skills
Must be able to successfully pass a CORI, reference check, and employment verification background checks
About Founded in 1977, for over 40 years the agency has been a leading nonprofit human services organization that “transforms lives” by building the capacity of individuals, families, organizations and communities to learn, thrive and achieve their goals. The agency supports thousands of adolescents and adults with psychiatric, developmental and behavioral disabilities at more than 200 sites with over 3,000 employees in eastern Massachusetts and Connecticut. Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, pregnancy, sexual orientation, gender identity, national origin, age, protected veteran status, or disability status.#Toponehire