Compliance and Risk Management Specialist

Job Description

Job Description

Title : Compliance and Risk Management Specialist

Location : 4822 N. Broadway Chicago, IL

Schedule : Hybrid, Monday - Friday 8 : 30am-5 : 00pm

Summary :

Under the general guidance of the Director Compliance and Risk Management, the Compliance and Risk Management Specialist is responsible for identifying, analyzing, evaluating, and mitigating risks within Heartland Human Care Services (HHCS) by conducting ongoing compliance reviews, assisting in participant grievance responses and providing overall support to the organization’s risk management (RM) department, and ensuring compliance with relevant federal / state / local regulations, guidance, laws and accrediting body standards.

Individual accountabilities and work volume will be established through the development of annual Success Objectives, within the framework outlined below.

The Compliance and Risk Management Specialist will work to follow required administrative standards, practices and coordinated risk management and compliance activities to support best practice outcomes for programs, services and departments.

This position collaborates with small to large cross-function teams at various levels of the organization. The Compliance and Risk Management Specialist leverages industry knowledge and best practices to promote the mission and vision of Heartland Human Care Services (HHCS).

Supports culture development and management efforts.

Our Benefits :

• Medical insurance. BCBS PPO, EPO, and HSA Plans
• Dental insurance.
• Vision insurance.
• 401(k) 3% Employer Contribution.
• Paid maternity leave.
• Paid paternity leave.
• Commuter benefits.
• Student loan assistance.
• Tuition assistance.
• Disability insurance
• FSA Spending Account
• Life Insurance
• Employee Assistance Program
• Special Vendor Discounted Offerings on Travel, Amusement Parks, etc.

Essential Functions :

Duties and Responsibilities :

Compliance and Risk Management

• Assesses risks and evaluates existing controls to ensure their adequacy and effectiveness in mitigating identified risks.
• Proactively identifies potential risks by monitoring and analyzing indicators, trends, and emerging issues, develop appropriate response plans.
• Leads and manages risk, compliance, and quality initiative implementations.
• Assists with the tracking, monitoring and compliance of risk management initiatives, goals, objectives, and action planning.
• Conducts and documents ongoing (i.e., weekly, monthly, quarterly, annually) compliance reviews of initiatives / programs and departments to ensure adherence to federal / state / local regulations, policies.
• Tracks initiative / program / department corrective action plans and findings status.
• Develops and submits regular (i.e., weekly, monthly, quarterly, annually) reports of compliance reviews, activities, and findings to department management.
• Conducts risk management and compliance related training sessions.
• Serves as a contributor on risk and compliance related committees / teams as assigned.
• Develops and supports risk management function standard operating procedures.
• Generates compliance and risk management data reports.
• Leads assigned agency risk management and compliance projects and initiatives as identified.
• Serves as system administrator for online risk management platform, software management, and reporting.

Regulatory Quality Assurance and CARF Accreditation Compliance

Conducts and documents ongoing compliance reviews of initiatives / programs and departments to ensure adherence to CARF Accreditation standards;

including onsite / in-person scheduled and unannounced reviews.

• Submits regular (i.e., weekly, monthly, quarterly, annually) reports of compliance reviews, activities and findings to department management.
• Assists with CARF accreditation adherence, compliance activities and survey review preparation.
• Serves as a contributor on risk and compliance related committees / teams as assigned and support coordination of committee deliverables.
• Conducts internal regulatory quality assurance audits; including onsite / in-person scheduled and unannounced audits.
• Supports the preparation of external program funder surveys and audits.
• Performs other related duties as assigned.

Participant Grievances

• Leads development and management of centralized and standardized participant grievance program across HHCS including framework, resolution SOPs, trainings to staff, and reporting.
• Develops objectives and tactics for participant grievance program.
• Interfaces with participants to respond, as appropriate for service recovery and resolutions of grievances or complaints.

Collaborates with programs on appropriate resolutions.

Leverages technology to track participant grievances and complaints, outcomes, and trends, and provides reports to leadership with insights and recommendations for continuous quality improvement.

Qualifications :

Education and / or Experience :

Minimum of a bachelor’s degree in social work, Human Services, Public Health, Health Administration or related field required.

Master’s Degree in Social Work, Human Services, Public Health, Health Administration or related field preferred.

• Prior human care and social services experience preferred.
• Minimum of 5 years’ experience with risk, quality assurance, compliance, or accreditation related projects
• Minimum of 5 years providing training or coaching staff on compliance or accreditation standards
• Minimum of 3 years direct experience interfacing with patient, participant, or program members with service recovery of their experience of services and resolving grievances and complaints.
• Knowledgeable about federal, state, and local standards / guidelines related to compliance, quality assurance (QA) and / or HIPAA / confidentiality preferred.

Knowledge / Skills / Abilities (K / S / A) :

• Demonstrated ability to lead change management.
• Confident and proficient with excel and generating data summary reports for various tiers of the organization.
• Demonstrated experience developing training materials for staff and external end users of services.
• Demonstrated experience with best practices in developing patient, participant, or member end user materials.
• Experience with Microsoft applications (Word, Excel and power point) required.
• Ability to execute projects with project management methods, templates, and tools.
• Strong organizational, verbal and written communication skills. Pleasant and professional attitude. The ability to function objectively in reviewing, monitoring, tracking and assessing program services.
• Excellent communication and relational skills required for interaction with staff / management and participants.
• Experience working directly with people from diverse racial, ethnic, and socioeconomic backgrounds.
• Strong time management and organizational skills. Demonstrates ability to manage multiple, parallel assignments with accountability for timely, cost-effective results.

Excellent analytical skills and ability to thrive in a fast-paced environment.

• Excellent communication skills. Strong networker, convener, relationship builder and communicator with experience collaborating with diverse work teams and stakeholders.
• Demonstrated ability to handle confidential and sensitive information possessing skills to handle situations in a professional and diplomatic manner.
• A high degree of collaboration and emotional intelligence, self-motivation, and analytical ability.
• Proficiency in Microsoft Office, Internet Explorer, Outlook / Exchange; Windows operating systems; and other software routinely used by Heartland Human Care Services.
• Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists.

Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.

• Ability to work independently and remain self-motivated with minimal direct supervision.
• Strategic thought partnership and consultancy skills.

Physical Demands :

• While performing the duties of this job, the employee is regularly required to use their hands to key, handle, or feel and reach with hands and arms.
• While performing the duties of this job, the employee is regularly required to talk or hear.
• While performing the duties of this job, the employee is regularly required to sit, stand; walk; climb or balance and stoop, kneel, crouch, or crawl.
• Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus.
• The employee must occasionally lift and / or move up to 30 pounds.

Work Arrangement

This role is a hybrid. If hybrid, it is expected this person would be able to meet for onsite and in person meetings, site visits and compliance reviews and activities when needed or at the request of others.

In-person meetings may be required on a regular basis (weekly, monthly, etc.). There may also be the availability to work from home when appropriate.

Work Environment :

• Flexible and comfortable work remotely and / or onsite.
• The noise level in the work environment is usually moderate.
• Moderate exposure to outdoor elements at all times of year when traveling to and from work sites via public transportation.
• The employee must be in possession of a valid driver’s license and be able to legally operate an agency owned or rented motor vehicle for transportation of equipment and to certain work sites.
• Program sites are located throughout the Chicago area, including North and South sides of Chicago, as well as the suburbs.

Equal Opportunity Employer Statement

Heartland Human Care Services makes all hiring and employment decisions, and operates all programs, services, and functions without regard to race, receipt of an order of protection, creed, color, age, gender, gender identity, marital or parental status, religion, ancestry, national origin, amnesty, physical or mental disability, protected veterans status, genetic information, sexual orientation, immigrant status, political affiliation or belief, use of FMLA, VESSA, military, and family military rights, ex-offender status (depending on the offense and position to be filled), unfavorable military discharge, membership in an organization whose primary purpose is the protection of civil rights or improvement of living conditions and human relations, height, weight, or HIV infection, in accord with the organization's AIDS Policy Statement of September 1987.