5-7 years of experience in healthcare compliance and quality assurance
In-depth knowledge of CMS Conditions of Participation and Virginia home health regulations
Proven experience in clinical documentation auditing and billing compliance
Strong analytical skills to identify compliance risks
Excellent communication skills for collaboration across departments
Detail-oriented with a proactive approach to managing compliance initiatives
Responsibilities
Lead the agency's compliance program to align with federal and state regulations
Serve as the main compliance contact, fostering accountability across departments
Develop annual compliance monitoring and risk assessment plans
Oversee regulatory readiness, including mock surveys and staff preparation
Conduct routine audits of clinical documentation and billing practices
Monitor quality measures and identify opportunities for improvement
Coordinate responses to survey findings and maintain compliance documentation
Benefits
Comprehensive training programs for new hires and ongoing staff development
Supportive culture promoting accountability and ethical practices
Access to a confidential compliance hotline
Opportunities for professional growth within the organization
Collaborative work environment with leadership involvement
Full Job Description
Lead compliance. Protect quality. Keep our organization survey-ready.
What You'll Do
Lead and maintain the agency's compliance program, ensuring alignment with federal regulations, Virginia home health requirements, CMS guidelines, and Joint Commission standards.
Serve as the organization's designated compliance point of contact, promoting accountability and ethical practices across all departments.
Develop and maintain annual compliance monitoring, auditing, and risk assessment plans.
Oversee regulatory readiness, including mock surveys, tracer activities, staff preparation, and documentation for Joint Commission and Virginia Department of Health visits.
Conduct routine audits of clinical documentation, OASIS accuracy, plans of care, billing, coding, and PDGM compliance.
Monitor HHVBP and quality measures alongside the QAPI program, identifying documentation trends and opportunities for improvement.
Coordinate responses to survey findings, including plans of correction and supporting evidence of compliance.
Monitor regulatory changes and communicate necessary updates and recommendations to organizational leadership.
Maintain the agency's Code of Conduct and confidential compliance hotline, ensuring a culture of accountability and non-retaliation.
Partner with Clinical Managers, the COO, CCO, and CEO to develop and deliver compliance training for new hires and existing employees.
What We're Looking For
Strong knowledge of healthcare compliance, regulatory requirements, and quality assurance practices.
Understanding of CMS Conditions of Participation, Virginia home health regulations, and Joint Commission standards.
Experience with clinical documentation auditing, billing compliance, and healthcare regulatory readiness.
Strong analytical and organizational skills, with the ability to identify compliance risks and recommend corrective actions.
Excellent communication skills and the ability to collaborate with clinical, operational, billing, and leadership teams.
A proactive, detail-oriented professional who can independently manage compliance initiatives and drive accountability throughout an organization.
