Regulatory Compliance Auditor

• Location 9401 SW Freeway,Houston, TX, 77074,United States
• Base Pay $64,208.00 / Year
• Job Category Professional
• Employee Type Full-time
• Required Degree 4 Year Degree

Are you ready to make a real difference in people’s lives? Join the Harris Center for Mental Health and IDD as a Regulatory Compliance Auditor. The Regulatory Compliance Auditor provides coordination between the Authority and contracted services programs by technical review of the medical records, billing service codes, contracts and other documents. The Regulatory Compliance Auditor is responsible for carrying out programmatic and departmental goals and objectives as stipulated by Texas Administrative Code (TAC), Medicaid Guidelines, Texas Resiliency and Recovery Guidelines, and Quality Practices of the Agency.

This position provides center‑wider oversight to the Intellectual Disability Division (IDD) and Mental Health Division (MH), Forensics and CPEP, related to compliance standards, state and federal guidelines, and contract requirements. This position is responsible for planning and scheduling ongoing audits, collaborating with managers, supervisors and additional staff regarding compliance standards. Travel will be required.

• Provides center-wide oversight which includes consultation with all program directors, managers, staff, and unit level program monitors.
• Conducts inter-rater reviews (review of unit level program monitor’s findings).
• Provides training/technical assistance and ongoing consultation to Agency divisions and units (inclusive of managers and staff).
• May participate in the hiring process for program monitor positions as requested.
• Develops new audit tools and revise/update current audit tools according to Agency P&P and state/federal guidelines.
• Completes technical reviews of records assuring compliance with all applicable guidelines and reviews of external contractors.
• Completes audit summary reports, preliminary debriefing reports and final debriefing reports.
• Reviews all deficiencies as cited and initiates Plans of Improvement (POI) if needed.
• Participates in state requested, focus, comprehensive and authority reviews.
• Participates with Agency committees or work groups, if applicable.
• Contacts sources to validate information received from case reading, sources, and consumers.
• Provides technical assistance to division programs on compliance issues, identifies trends or problems, and recommends appropriate changes in service delivery.
• Provides input on the development of quality control policies, procedures, and protocols.
• Completes operational (site) and State Mystery caller reviews.
• Participates in assigned Agency investigations and in training and meetings to determine areas for compliance.
• Coordinates and adheres to State and Insurance requests.
• Logs and tracks compliant calls and incident reports received in the Department.
• Facilitates staff in‑services on compliance policies, procedures, and protocols/review tools.
• Completes assigned reviews and reviews of external contractors.
• Performs other related duties as assigned.

Education:

• Bachelor’s degree (B.A.) or equivalent.
• Certified in Healthcare Compliance, Certified Compliance and Ethics Professional preferred.

Experience:

• One (1) year of experience reviewing or auditing programs that provide behavioral health services or IDD services required OR Two (2) years of experience working in social service with duties to include documentation and record keeping required;
  Five (5) years of experience preferred.

• Knowledge of federal program policies and laws, of financial and medical eligibility program policies, and of agency quality control procedures.
• Knowledge of Microsoft Word, Excel, Access, Power Point and Outlook. Knowledge of HIPAA Privacy and Security Rules.
• Possess strong verbal and written communication skills and interact effectively at all levels within the organization.
• Ability to interpret policies and procedures, analyze and evaluate quality control case review documentation for accuracy and completeness, to analyze management problems and develop and present alternative solutions. Works with…