Remote Compliance and Risk Analyst

Summary

Join our team at FreedomCare as a Compliance & Risk Analyst and make a positive impact on the lives of others! This remote position involves assisting in building training programs for caregivers, monitoring adherence to training requirements, and reporting to Compliance Managers & General Managers. The role will also be responsible for audit responses, state required in-home visits, complaint and incident reporting, physical site visits, and process review/enhancement.

Requirements

• Strong working knowledge of auditing procedures; prior 3-4 years of applying such guidelines for overall compliance with a large scope preferrable in the healthcare sector, healthcare/hospital facility/system, or Insurance provider
• Strong working knowledge of billing and diagnosis codes that would permit proper auditing of reimbursement payments, insurance billing and claims for a healthcare services/products provider
• Minimum of 5 years of experience with progressively increasing responsibility (coaching employees on guidelines, functions, etc.)
• Prior working experience driving change
• New program/system implementation experience
• Must possess a compliance mindset with a high level of attention to detail, a proven ability to understand compliance regulations and an understanding of how those regulations apply to specific situations
• Documented ability and success in working cross-functionally to attain/maintain compliance with guidelines and regulations
• Background in creating training modules which support a variety of audiences within an organization
• Experience driving results in a direct and dotted line reporting environment
• Active participation in audit responses with established success rates

Responsibilities

• Assist in building both initial and annual training programs for caregivers in each state in which FreedomCare operates
• Monitor adherence to training requirements and report to the Compliance Managers & General Managers of each state when caregivers are at risk of non-compliance
• Be the main point of contact for audit responses regarding training programs
• Report functions for state required in-home visits, consistently monitoring upcoming home visits and identifying trends to report to the Compliance Managers & General Managers of each state when the company is at risk of non-compliance
• Be the main point of contact for audit responses regarding in-home visit percentages
• Monitor open complaints and critical incident reports to maintain compliance with closing cases within a timely period that will either be defined by the state guidelines or within 72 business hours
• Identify trends and report to the Compliance Managers & General Managers of each state if the company is at risk of non-compliance
• Be the main point of contact for audit responses regarding complaint and incident reporting
• Conduct physical site visits to audit compliance with policies and guidelines regarding state-required postings
• Conduct regular and retrospective audits in new and existing states to ensure consistent adherence to compliance guidelines
• Support the Compliance Department in preparing for and managing internal, external, Medicaid, and State audits and inspections
• Function as a key liaison in audit readiness and response strategies, improving compliance controls based on audit outcomes
• Help build out state-specific training when gaps are identified
• Train the General Managers in each state on new/updated requirements and how to enroll all necessary team members in required training
• Collaborate with General Managers and staff to identify caregiver compliance training needs, focusing on specific gaps identified through audits and operational feedback
• Identify gaps in training programs for front line operations team members considering state-specific requirements and changes in healthcare regulations
• Lead the effort to document all training identified and implemented while ensuring it is standardized with the Learning, Training and Development and Compliance departments as necessary
• Monitor and evaluate the effectiveness of training sessions, ensuring continuous improvement in compliance adherence by auditing service records and providing feedback during early stages of launching in a new state

Benefits

• Competitive compensation
• Medical benefits
• Retirement plans
• Wellness programs
• Fun company events
• Ongoing learning opportunities to grow your career