Director of Compliance

Company Overview

Spring Dell Center, Inc. is dedicated to assisting individuals with disabilities in achieving their highest level of independence by providing support and employment opportunities for the quality of life they desire within their community. Our employees are responsible for providing the highest quality of individualized services. Our ultimate goal is to promote full community integration for individuals with disabilities.

Director of Compliance

Job Type: Exempt Full Time

Salary: $65,000-$70,000 annually
Location: Spring Dell Center, Inc., La Plata, MD

Salary: TBD

Duties of Position: LTSS and Billing compliance

The Director of Compliance will be compensated $65,000 – $70,000 based on experience and is responsible for the implementation of Company and Medicaid Compliance processes. They ensure the agency is properly following regulations/requirements set by State and Federal entities. More specifically the Director shall:

A. Assure compliance with State and Federal funding and licensing entities related to program services, contracts, billing and Quality Assurance.

B. Assure compliance and billing accuracy while maximizing funding and optimizing funding programming with the person-centered planning process.

Essential Functions:

Reviews data tracking systems for compliance to ensure services and funding are aligned.

1. Conducts monthly file reviews in each department to ensure compliance with COMAR regulations related to rights, nursing plans, BSP’s, etc.
2. Assure service delivery is documented in iCareManager (iCM) to validate accurate compliance for billing.
3. Implements conversion to fee-for-service model (PCIS2) to LTSS model.
4. Review quarterly programs with agency policies and procedures and external regulations, including OHCQ, DDA, licensing and MSDA audits and works closely with the leadership team to ensure a smooth provision of services.
5. Assure staff are up to date with the accurate systems of completing documentation for documentation of services used for billing.
6. Attends and participates in State LTSS meetings, MACS Quality Assurance meetings and So. Md. Regional meetings.
7. Attends and participates in iCM Huddles and EAG meetings. Contacts iCM helpdesk when issues arise with iCM. Maintain iCM database for entire agency.
8. Coordinates departmental and interdepartmental sessions working collaboratively to facilitate a cohesive and comprehensive understanding of compliance.
9. Develops reports to track attendance, training, compliance.
10. Participate in new hire orientation to review LTSS and iCM.

C. Developmental Disabilities Administration (DDA) Compliance Assurance for:

1. Eligibility, Waiver, authorization for PCP’s and services, and billing.
2. Required documentation for service audits and billing.
3. DDA approvals for provider payment.
4. DDA guidance and protocols.

D. LTSS Compliance Assurance for:

1. Service definitions for all services.
2. Units/hours/15-minute units, milestone billing.
3. Accuracy of services, supplemental supports, units, rates and supporting documentation.

E. The PCP:

1. PCP collaboration with Program Coordinators to assure completion and accuracy of the PCP to approve and bill for services rendered.

F. QA Functions:

Ensuring compliance with community settings final rule. Works with Program Services and QA to ensure that corrective action steps are in place, implemented and documented.

1. Submits data for quarterly QA reports.

G. Fiscal Office Interface:

1. With the Finance Office, develop and implement protocol to assure the authorization processes lead to accurate billing for services rendered.

Program Support

1. Responsible for assisting the Director of Human Resources in recruitment of all Compliance Departmental staff.
2. Responsible for interviewing and hiring of new staff.

Supervision

1. Responsible for supervising and evaluating departmental staff as assigned.
2. Provide comprehensive orientation to all new supervised employees.
3. Complete 90-day reviews, annual evaluations and corrective actions following SDC Personnel Policies and Procedures.
4. Ensure staff compliance with policies.
5. Build staff morale, commitment, and positive teamwork.
6. Responsible for coordination of leave requests and coverage for each site/program

Qualifications and Skills

Minimum Requirements:

• Excellent writing skills and knowledge of spreadsheets
• Proficient with software applications
• Proficient with attention to detail with services authorizations and billing
• Experience with Quality Assurance Reviews
• Experience with budget development and implementation

Preferred Requirements:

• 2 years of supervisory experience
• Knowledge of DDA processes, COMAR and Waiver regulations, and DOL regulations
• Knowledge of the PCIS2 and LTSS Payment systems a plus
• Knowledge of Quality Assurance Processes and Investigations
• Bachelor’s degree in a relevant field

Benefits and Perks

• Paid Training
• Paid Travel Expenses
• Paid Holidays (10)
• Health Insurance
• 403b Retirement Plan
• Tuition Reimbursement
• Free $10,000 Life Insurance/Accidental Death and Dismemberment
• Workmen’s Compensation
• Direct Deposit
• Annual Leave
• Sick Leave
• Military Leave
• Jury Duty Leave
• Bereavement Leave

Spring Dell Center, Inc. is an equal opportunity employer promoting a drug-free, smoke-free workplace.