Director of Risk and Compliance

The Director of Risk and Compliance supports the Chief Risk and Compliance Officer (CRCO) in the development, implementation, expansion, sustainability, and continuous improvement of HealthLinc's risk management, corporate compliance, and privacy and security initiatives.

This position is responsible for the operational oversight and execution of day-to-day compliance and incident management activities, as well as key organizational initiatives such as accreditation and Patient-Centered Medical Home (PCMH) recognition.

This role promotes a risk-aware, ethical, and compliant organizational culture through collaboration with senior leadership, clinical staff, and site staff.

JOB RESPONSIBILITIES: Risk Management Responsibilities: * Under the direction of the CRCO, assist in the development and day-to-day management of HealthLinc's corporate-wide risk management program.

* Maintain accurate documentation for risk management activities, including policies and procedures, for continuous accreditation and audit readiness.

* Manage and operationalize policies and procedures related to the risk management program.

* Assists the CRCO in the development of HealthLinc's written, organization-wide risk management plan that is reviewed and board-approved at least annually * Plans and conducts frequent, but no less than quarterly, organizational self-assessments that identify areas of highest clinical risk and result in complete action plans with documented follow-up.

* Plan, create and conduct risk management training for all staff, pertinent to their job role and focusing on identified areas of high risk.

* Assists the CRCO in maintaining HRSA and FTCA compliance and with the completion of the annual FTCA deeming application.

* Analyze and correlate data from risk management activities to organizational goals and objectives.

* Oversee the internal incident reporting process; review incident reports, provide oversight, and conduct follow-up investigations, as needed.

* Investigate and evaluate claims and potential claims in coordination with the CRCO.

* Support the management and processing of claims-related activities, act as a secondary point of contact for claims.

* Ensure preservation of documentation related to claims or complaints.

* Assist in quarterly reporting to internal committees and the Board, as delegated by the CRCO.

* Lead and report on improvement efforts using the Plan-Do-Study-Act (PDSA) methodology and operationalize improvement efforts with the Quality Improvement (QI) and Operations departments.

* Collaborate with Human Resources on worker's compensation and OSHA-related issues in coordination with the CRCO.

* Encourages a strong culture of safety in which all members of the organization prioritize patient safety.

* In the absence of the CRCO, acts as the organization's Risk, Compliance, and Privacy Officer including exercising all of the professional responsibilities associated with those roles.

Compliance Responsibilities: * Manage and operationalize policies and procedures related to corporate compliance under the strategic direction of the CRCO.

* Coordinate compliance-related training programs, including onboarding and ongoing staff development.

* Monitor and report on compliance activities across departments, identify areas of vulnerability, and support corrective actions.

* Manage and operationalize incident management system and maintain compliance communication initiatives to increase awareness and understanding.

* Track, audit, and monitor adherence to regulatory guidelines and best practices to identify areas of risk or vulnerability.

* Support the execution and management of the Corporate Compliance Workplan in alignment with the OIG's Seven Elements of an Effective Compliance Program.

* Prepare documentation and support organizational readiness for audits and HRSA On-Site Visits.

* Coordinate and participate in committees and meetings to represent risk and compliance matters as assigned.

Accreditation and Patient-Centered Medical Home (PCMH) Responsibilities: * Lead all facets of the ambulatory health care accreditation and PCMH program, including maintenance of AAAHC requirements and status.

* Serve as the organization's subject matter expert on accreditation and PCMH standards, policies, processes, and application requirements.

* Develop, implement, and manage project plans required for achieving and maintaining accreditation and recognition.

* Collaborate with clinical educators to design and deliver training programs that align workflows and organizational culture with PCMH standards.

* Facilitate the development and implementation of policies and procedures supporting accreditation and PCMH recognition.

* Monitor changes to accreditation and PCMH standards and ensure HealthLinc remains compliant with evolving requirements and expectations.

* Partner with the QI team to align accreditation and PCMH efforts with organizational performance improvement goals.

* Provide data and recommendations for department improvement projects, workflow optimization, community health initiatives, staff training, and payer incentive program participation.

* Document and communicate the value and outcomes of the PCMH model to internal and external stakeholders, including local, state, and federal entities.

* Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job.

Duties, responsibilities, and activities may change at any time with or without notice.

Qualifications REQUIRED QUALIFICATIONS: Education/Training * Bachelor's degree in related field * Master's Degree highly preferred * Preferred certifications: Certified Healthcare Compliance (CHC), Certified Healthcare Privacy Compliance (CHPC), Lean Six Sigma Green Belt preferred Experience * 3-5 years' experience in healthcare risk management and/or compliance preferred * At least 1-3 years' experience in navigating Federal Regulations and Statutes including OIG, DOJ, CMS, and OCR to support Compliance and Privacy Officers preferred Skills/Job Requirement * Strong organizational and time management skills * Proven ability to work well in a team environment * Advanced written and verbal communication skills * Must possess and demonstrate critical thinking and active listening skills * Ability to remain flexible and adaptable * Ability to follow HealthLinc policies and procedures Technology Skills * Operate a multi-line phone system and other office equipment including printers, fax machines, etc.

* Basic software skills (Microsoft Office, EHR, online sources, etc.)