Compliance & Quality Systems Specialist (Knox or Hamilton)

Helen Ross McNabb Center
Knoxville, Tennessee
Jun 02, 2024
Jun 13, 2024
Position Type
Full Time
Work Mode
Employment Type
Organization Type
Corporation / LLC
Job Description Compliance & Quality Systems Specialist (Knox or Hamilton)
Help Others, Make a Difference, Save a Life.

Do you want to make a difference in people's lives every day?
Or help people navigate the tough spots in their life?
And do it all while working where your hard work is appreciated?

You have a lot of choices in where you work make the decision to work where you are valued!

Join the McNabb Center Team as the Compliance & Quality Systems Specialist program today!

The Compliance & Quality Systems Specialist


Summary of role of team:
  • The purpose of the Compliance & Quality Systems team is to support the organization in ensuring compliance with all regulatory requirements, accreditation, risk management, and quality improvement activities.
  • The team interacts with senior leadership within the organization as well as external stakeholders.
Summary of position:
  • The Compliance and Quality Systems Specialist will assist the Compliance and Quality Systems Coordinator in conducting departmental functions, such as and not limited to, researching evidence-based practices, quality initiatives, program outcome measures, collecting and reporting data from various data points, assisting in the improvement of the overall quality of services provided by the Center, and investigating Corporate Compliance and Privacy concerns.
  • This staff person will interact with all levels of the organization that employ patient data in decision-making and daily operations.
  • This position typically operates in that office.
  • To complete some job tasks, traveling to another organization facility is required.
  • These other facilities include supportive residential home, residential treatment facilities, and outpatient centers.

This job description is not intended to be all-inclusive; and employee will also perform other reasonably related job responsibilities as assigned by immediate supervisor and other management as required. This organization reserves the right to revise or change job duties as the need arises. Moreover, management reserves the right to change job descriptions, job duties, or working schedules based on their duty to accommodate individuals with disabilities. This job description does not constitute a written or implied contract of employment.

1. Internal Auditing - Responsible for conducting internal reviews of clinical documentation and coding/billing; ensures organization compliance with all regulatory requirements

  • Conducts monthly internal audits as scheduled by the Services Coordinator.
  • Ensures accuracy of findings by coordinating with HIM staff.
  • Compiles audit results and reports findings to the Corporate Compliance Committee monthly.
2. External Auditing - Responsible for coordinating external audits

  • Coordinates with external stakeholders to schedule and organize audits when requested.
  • Coordinates with internal staff to schedule and organize external audit needs.
  • Disseminates audit results within two days of receipt.
  • Provides any potential corrective action plans to external stakeholders by the date requested.
3. Compliance Investigations - Conducts compliance investigations as reports are received.

  • Completes investigations within two weeks.
  • Writes reports to Assistant Vice President of Organizational Excellence.
  • Completes reports to be reviewed in the Corporate Compliance Committee monthly.
4. Client Inquiry and Appeal - Receives client inquiries and manages inquiry process

  • Communicates with clients to resolve issues and file formal inquiries.
  • Communicates with staff to investigate issues and communicate results to clients.
  • Maintains records of inquiries and develops reports for monthly Quality Assurance/Quality Improvement Committee meetings.
5. Policy and Procedure Adherence - Follows Center and department policy and procedures

  • Attends mandatory sessions/meetings/in -services 100% of the time.
  • Reviews policy and procedure updates.
  • Demonstrates knowledge and application of Center and department policies and procedures.
6. Regulatory/Accreditation Adherence

  • Reviews the OIG Work Plan on a monthly basis and reports any applicable updates to the Compliance and Quality Systems Coordinator.
  • Plans for conformance with new or revised CARF accreditation standards with assistance from the QA/QI committee.
7. Teamwork/Committee Involvement - Participates collaboratively in committees, projects, and interdepartmental teams to meet goals

  • Completes assignments by target date 100% of the time.
  • Reviews and contributes to the attainment of departmental goals annually.
  • Participates and contributes to team projects.
  • Takes initiative and brings own unique strengths to projects.
  • Maintains a quality improvement focus and actively participates in improvement efforts.
8. Data Collection and Reporting - Responsible for collecting data and managing reports as required

  • Collects information such as, but not limited to: contact logs, sentinel event reports, client and referral satisfaction surveys, peer reviews, internal audit outcomes, external audit outcomes, and quality initiative data.
  • Supports clinical staff by collecting, cleaning, aggregating and disseminating weekly and monthly data related to hospitalizations, gaps in care, high utilizers, and other client care related information.
  • Collects, enters, reports, and analyzes Quality Record Reviews from Center programs. Report to QA/QI committee.
9. HIPAA Risk Assessment

  • Completes annual HIPAA privacy risk assessments at all identified organization locations.
  • Completes annual HIPAA privacy risk analysis and works with facility/program staff to complete any needed corrective actions.
10. Staff Training

  • Maintenance of Relias training modules: Corporate Compliance/Fraud/HIPAA, Non-
    Discrimination & Title VI, Incident & Med Error Reporting, Privacy & Confidentiality, Social Media Policy, CARF Accreditation, CARF Hot Topics, Quality Improvement-All Staff, Quality Improvement-All Supervisors.
  • Conducts weekly New Staff Orientation training related to compliance and quality subject matter.
  • Participates/facilitates Center wide CARF trainings.
  • Starting salary for this position is approximately $44,852 /yr based on relevant experience and education.
  • The required schedule for this position is Monday through Friday 8:00 am to 5:00 pm.
  • Hours outside of normal business hours may be required periodically if job duties require it.
  • Flexibility with the schedule will be considered for special circumstances.
  • In-person daily attendance is essential for this position.
  • This position does require some travel between the Centers facilities.
  • Most travel is a day trip and not overnight.
  • The employee will not use a center owned vehicle for travel.
  • Must have a valid driver's license and car insurance.
Equipment/Technology :
  • This position requires the use of a computer.
  • Proficiency in Microsoft Office Suite required.
  • The candidate should be able to learn and adapt to the use of various platforms used for tracking, data analytics, and auditing.
  • This position also requires the use of the electronic medical record.
QUALIFICATIONS - Compliance & Quality Systems Specialist

  • Graduation from an accredited university or college with an undergraduate degree in Public Health, Healthcare Administration, Social Work, Psychology, Counseling or related field.
  • Bachelor's eligible.
  • Master's preferred.
Experience / Knowledge:
  • Two years' experience in a healthcare setting; behavioral health preferred and/or experience in a compliance related field with preference given to candidates with experience in behavioral health.
  • Knowledge of federal, state, and payer-specific regulations and policies preferred.
  • Knowledge of healthcare quality and data analytics preferred.
  • Knowledge of HIPAA and privacy of protected patient information preferred.
  • Knowledge of corporate compliance program activities preferred.
  • Ability to hear normal voice and ring tones.
  • Standing, sitting, walking, bending.
  • Reach above shoulder height.
  • Pulling/pushing.
  • Lifting/carrying under 25 pounds.
  • Stair climbing.
  • Must be able to conduct analysis of data from a variety of sources.
  • Ability to interpret policies and regulations.
  • Ability to develop creative solutions to challenges.
  • Strong oral and written communication skills.
  • Must have understanding of healthcare ethics and a high degree of professionalism.
  • Must be highly organized and detailed.
  • . click apply for full job details