Director of Medical Compliance & Quality Irvine HQ (A)

Director of Medical Compliance & Quality

Full Time • Irvine HQ (A)
Benefits:
  • Dental insurance
  • Health insurance
  • Paid time off
  • Vision insurance
The Director of Medical Compliance & Quality is a key leader responsible for ensuring that all clinical practices and business agreements adhere to all relevant regulations, requirements and quality standards within a psychiatry and substance use treatment environment. The Director will manage compliance programs, develop standard operating procedures (SOPs) to enhance compliance and quality of care, review contracts, and conduct regular audits. The Director will also serve as the PNS subject matter expert on compliance and act as a central resource for all compliance-related matters. 
 
Responsibilities: 
  • Develop and manage compliance programs focused on clinical, medical, and patient privacy policies, including patient consent forms. Build SOPs to address relevant healthcare regulations including the requirements of 42 CFR Part 2. 
  • Raise the standard of care for all program levels: clinical research, outpatient, partial hospitalization (PHP), intensive outpatient (IOP), step-down, and acute/emergency department (ED) settings. 
  • Develop methods to track, audit, and mitigate potentially high liability incidents within our clinical services. 
  • Partner with the Chief Medical Officer and Billing Team to establish improved compliance procedures and billing best practices. 
  • Carefully review contracts to ensure the company meets all requirements, implementing changes and/or collaborating with other departments as needed. 
  • Guide and educate employees on compliance requirements, offering direction on ethical conduct, and providing training on relevant regulations and policies.  
  • Monitor changes in healthcare laws and contract requirements, ensuring that the organization's compliance program reflects these changes.  
  • Prepare reports for senior management on compliance activities and findings, and communicate compliance information to all levels of the organization.  
  • Collaborate with various departments to ensure the consistent application of compliance policies and procedures. 
  • Ensure proper documentation of compliance activities, including policies, procedures, training records, and audit results.  
  • Investigate and respond to compliance-related complaints or issues. Develop corrective action and prepare reports as required. 
 
Qualifications: 
  • Bachelor’s degree in healthcare administration, business, law or a related field. 
  • Master’s degree in Healthcare Administration, Juris Doctor or other advanced degree is preferred.  
  • Minimum of 5-7 years of experience in healthcare compliance; mental health industry experience preferred.  
  • Strong knowledge of healthcare regulations. 
  • Familiarity with CA medical compliance and Medicaid/Medicare. 
  • Extensive experience developing SOPs, reviewing contracts, conducting audits, and risk assessments within the healthcare field.  
  • Excellent communication, leadership, and problem-solving skills.  
  • Certified in Healthcare Compliance (CHC), Certified Compliance and Ethics Professional (CCEP) or related certifications is a plus. 
 
Location: In-office in Irvine, CA 
Salary range: $140,000-$170,000 per year 
Compensation: $140,000.00 - $170,000.00 per year




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