Risk Management & Compliance Director

Job Overview

The Director of Risk Management & Compliance will be responsible for ensuring The Whole Child (TWC) adheres to all contract requirements, applicable laws, regulatory entities, and accrediting bodies while minimizing the risks to the organization. This position will provide supervision and performance management for the staff in the department, as well as serve as the primary contact for accrediting bodies and assigned stakeholders as needed. The Director Risk Management & Compliance will lead all aspects of the accreditation process and program audits. This position is a part of the senior leadership team and reports to the Chief Administrative Officer.

Essential Functions:

• Supervisory responsibilities: Three exempt staff.
• Develop and implement a comprehensive compliance program that includes policies, procedures, and training for staff to ensure compliance with applicable laws, regulations, and industry standards.
• Risk Management/Business Continuity-Disaster Recovery: Provide regulatory analysis and implementation, including oversight, analysis, and communication of regulatory changes to stakeholders.
• Monitors and communicates changes for in program contracts, policies, and other Federal, State and County guidelines/protocols. (Including Medi-Cal Provider Recertification and Council on Accreditation)
• Conducts regular risk assessments to identify potential risks to the organization; develops strategies to mitigate those risks.
• Responsible for internal coordination of program audits and reaccreditation activities.
• Coordinates commercial insurance policy management and distribution of Certificate of Insurance (COI).
• Manages grievance and compliance related investigations and incidents, ensuring proper corrective actions are taken, documented, and tracked.
• Ensures desk level procedures and other key documentation are developed and reviewed.
• Prepare executive summaries, reports, and presentations; develops and conducts training activities for leadership, staff and the Board of Directors as needed.
• Implements the philosophy of quality improvement organizationally by developing and mentoring staff across TWC (i.e., mental health, housing, nutrition, home visitation, administration).
• Build, manage, motivate, and develop teams to monitor and drive consistent quality, efficiency, and enhanced solutions that meet the defined high-quality standards.
• Lead and serve on internal committees and workgroups.

Required Qualifications

• Bachelor's degree in healthcare management, public health, business administration, or related field required.
• At least five years of progressive healthcare compliance and/or audit experience required.
• Knowledge of healthcare and non-profit operations, regulations, and compliance requirements.
• Excellent verbal, written communication and presentation skills required.
• Strong attention to detail and ability to maintain accurate documentation.
• Strong analytical and problem-solving skills.
• Excellent communication skills and the ability to communicate complex issues to a variety of internal and external stakeholders.
• High level of personal integrity and possess the ability to professionally handle confidential matters.
• Two years supervisory experience.
• Valid California driver's license, access to an automobile, and valid state auto insurance.

Preferred

• Master's degree
• Experience with electronic medical record (EXYM)
• 2 years quality improvement experience

Our client acknowledges that equal opportunity for all persons is a fundamental human
value. Each employee and applicant will be considered on the basis of individual ability and merit, without regard to race, color, religion, age, sex, sexual orientation, gender identity, gender expression, pregnancy, national origin, marital status, physical disability, mental disability, medical condition, genetic information, protected military or veteran status, or any other characteristics.

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