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Employer: Sedgwick County
Division: COMCARE
Job Title: Compliance and Performance Improvement Specialist
Salary: $42361.28 Annually


Veterans' Preference is available for this vacancy.
To receive Veterans' Preference, you must supply a copy of your DD214 to the Human Resources department at Sedgwick County after applying.


Job Description:

Job Objectives:

Responsible for executing corporate wide coordination and administration of utilization review and compliance auditing and monitoring related activities as well as tracking and mitigating organizational risks and patient experience concerns.

Regular, reliable, and non-disruptive attendance is an essential job duty, as is the ability to create and maintain collegial, harmonious working relationships with others. Employee must be able to complete complex tasks by applying standard office policies, authorized instructions, and past precedents to achieve a desired outcome. Employee must quickly recognize emergency or sensitive situations and take appropriate action. Critical decision making and the ability to think through the consequences of a decision are essential in this position.

 

Essential Job Functions:

Quality and Risk Management Activities

  • Receive, enter and trend incident reports, follow up as needed and identify areas of risk and/or areas for improvement.
  • Receive, investigate, document and trend patient complaints.
  • Assists staff in the utilization of Relias learning management system, maintains accuracy of staff hierarchy and assists other human service divisions with uploading training courses.
  • Participates in Quality, Risk Management and Compliance Oversight Committee.
  • Champion or participate in work groups aimed at improving organizational performance and patient experience of care.
  • Assists in new initiatives or innovative practices.
  • Coordinates agency and medical service patient experience surveys and summarizes responses for Strategy Team.
  • Initiates HIPAA Breach Review forms for committee review.

Coordinates utilization and compliance review activities to comply with state and federal mandates

  • Assists the Director of Quality, Risk Management and Compliance with the investigating any reports of fraud, waste or abuse concerning billing or documentation of services.
  • Performs retrospective record reviews and audits with a focus on quality and risk indicators as it relates to utilization of resources, documentation guidelines, contractual obligations, compliance and medical necessity.
  • Generates agency documentation of utilization and compliance review activities which include identified trends, risks, and areas for improvement.
  • Meets with supervisors to review audit findings and create plans for improvement.

Consultation and Education

  • Assists with responding to external auditors and onsite reviewers during site visits.
  • Is available to Directors, supervisors, other COMCARE employees and business partners for review and discussion of regulatory requirements and agency policy.
  • Identifies and delivers trainings with internal and external customers around service definitions, fraud/waste/abuse and compliance
  • Assists with agency training around a broad range of issues.
  • Completes routine and ad hoc agency reports.

Seconday Functions

  • CPI trainer, coach for Beating the Blues participants, special projects of short term nature.
  • Cultivate and maintain working relationships internal and external to COMCARE.

 

Competencies:

Adaptability:  Adapts well to changes in assignments and priorities; adapts behavior or work methods in response to new information, changing conditions, or unexpected obstacles; approaches change positively and adjusts behaviors accordingly; focusing on being part of the solution.

Analytical Thinking:  Works systematically and logically to resolve problems, identify causation and anticipate unexpected results.  Manages issues by drawing on own experience and knowledge and calls on other resources as necessary.

Collaboration/Relationship Building:  Establishes rapport and personal connections, while maintaining professional boundaries. Builds constructive working relationships with clients/customers, other work units, community organizations and others to meet mutual goals and objectives. Behaves professionally and supportively when working with individuals from a variety of ethnic, social and educational backgrounds.

Communication:  Clearly conveys and receives information and ideas through the appropriate methods and media for target audiences in a manner that engages the listener, helps them understand and retain the message, and invites response and feedback. Ensures appropriate stakeholders are kept informed and that information shared is accurate and timely.  Demonstrates good written, oral, and listening skills.

Customer Focus/Client Orientation:  Makes customers/clients and their needs a primary focus of one’s actions; makes a conscious effort to include diversity of input in all decisions; shows interest in and understanding of the needs and expectations of internal and external customers (including direct reports); acts with customers in mind and strives for continuous improvement in products and services. Gains customer trust and respect; meets or exceeds customer expectations.


Job Standards:

Educational Requirements:   Master’s degree from an accredited college or university in Social Work, Psychology or other Human Service Field.   Demonstrated knowledge of quality improvement principles and regulatory compliance as well as an ability to understand and apply applicable state and federal regulations relevant to mental health, substance abuse, HIPAA and corporate compliance.  Demonstrated ability to form quick and lasting relationships and ability to communicate audit findings in ways that others do not feel criticized.  Knowledge and experience with collaborative leadership and working within teams, as well as, across and up/down an organization is required.

Years of Experience:  3 years’ experience in a physical or behavioral health setting with progressive responsibility or any equivalent combination of training and experience which provides the required knowledge, skills and abilities.

License, certifications, etc… Must possess a Master’s Degree in a Human Service field and hold respective licensure at the Master level with the State Behavioral Science Regulatory Board.   Must have a valid Kansas Driver’s license and current proof of automobile insurance. Must be able to safely operate a motor vehicle and meet driver qualification standards as set forth in Sedgwick County’s Fleet Vehicle Operation and Usage policy.  Meet the specifications as outlined in the CMHC licensing standards and pass KBI, DCF child abuse check, adult abuse registry, and motor vehicle screens.  Must complete orientations provided by Sedgwick County and COMCARE.

 

Physical Requirements of Position:

Mostly sedentary, but occasional light work. Exerting up to 20 pounds of force occasionally, and/or up to 10 pounds of force frequently, and/or a negligible amount of force constantly to move objects. If the use of arm and/or leg controls requires exertion of forces greater than that for sedentary work and the worker sits most of the time, the job is rated for light work.

The worker is required to have close visual acuity to perform an activity such as: preparing and analyzing data and figures; transcribing; viewing a computer terminal; extensive reading; visual inspection involving small defects, small parts, and/or operation of machines (including inspection); using measurement devices; and/or assembly or fabrication parts at distances close to the eyes.

 

Testing/Screening Requested:

• Background checks including but not limited to KBI and DCF adult and child abuse registry • Motor vehicle screening • Pre-employment drug screen

 

Equipment:

Modern office equipment

 

Work Environment:

Usual working days/hours:  Monday - Friday, 8:00 a.m. to 5:00 p.m.

Location of work:  271 W 3rd St N

 

*Please note this job posting 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*

*This position may be filled or closed to further application without notice. Must be at least 18 years of age to work for Sedgwick County*

It is the policy of Sedgwick County not to discriminate in its programs or services provided to the general public, including employment and all other activities, on the basis of race, color, religion, national origin, citizenship, sex, age, disability, veteran status or any other similarly protected status. Sedgwick County is committed to making the application, interview, and pre-employment testing process accessible to persons with disabilities. If you wish to volunteer information regarding any special assistance you may need, please notify Crissy Magee, Sedgwick County ADA Coordinator, by phone (316) 660-7056, TDD (Kansas Relay at 711 or 800-766-3777), or email at crissy.magee@sedgwick.gov. Do not send resumes or application status request or employment questions to this email or phone number. This information is provided only for those requiring ADA assistance. Applications must be submitted on www.hrepartners.com. You will be contacted should the department feel that you are a qualified candidate. Sedgwick County will prohibit the hiring of spouses and/or immediate family members within the same department, but not within the County structure.



Vacancy Number: 20002618

Open Date: 8/7/2018 12:00:00 AM
Close Date: 11/25/2018 11:59:59 PM