Title: Health Care Compliance Specialist II
State Role Title: 49172
Hiring Range: Negotiable based on relevant years of experience
Pay Band: 5
Agency: Dept Behavioral Health/Develop
Location: Southern Va Mental Health Inst
Agency Website: https://dbhds.virginia.gov/facilities/svmhi/
Recruitment Type: General Public - G
Job Duties
To assist and oversee in the planning, development, implementation, monitoring, education, and training to promote a Medicare Voluntary Compliance Program and related Risk Management and Quality Improvement programs. Works with Utilization Management Coordinator to ensure compliance with applicable CMS Conditions of Participation.
Minimum Qualifications
Previous experience in a healthcare setting required.
Experience in the compliance profession to include investigations and health information management required.
Clinical/direct care delivery experience in an inpatient psychiatric setting required.
This position will also include:
Knowledge of 1) Medicaid and Medicare administration policies and practices, 2) Clinical Documentation, 3) Administration and training principles and practices, 4) Applicable Federal, State, and Departmental laws, regulations and policies Skills include: 1) Problem Identification, 2) Information Gathering, 3) Organization, 4) Critical Thinking, 5) Interpersonal Diplomacy/Professionalism. Knowledge of inpatient psychiatric treatment and documentation required, to include interdisciplinary treatment planning, discharge planning, and psychosocial rehabilitation. Functionally adept at working within EHR system –Millennium. Ability to communicate effectively, both orally and in writing, with clinicians, administrators, and Individuals. Ability to assist with Utilization management principles, third party reimbursement systems, and associated legal/regulatory requirements. Basic computer skills in typing, Microsoft Word, and Microsoft Excel. Ability to write policies, procedures, and instructional tools; design forms; and produce memorandums, agendas, and minutes. Ability to work independently to include organization, prioritization, and maintain timelines of multiple tasks/projects.
Additional Considerations
Experience assisting with regulatory surveys, i.e., Joint Commission, CMS, VDH, OSIG.
One of the following education, training and/or experience is desirable:
Licensure as a Registered Nurse
Bachelor of Social Work
Veterans and people with National Service.
Special Instructions
You will be provided a confirmation of receipt when your application and/or résumé is submitted successfully. Please refer to “Your Application” in your account to check the status of your application for this position.
Applicants must list all relevant experience that you wish to be considered for this position. Applicants will be provided confirmation of receipt when your application and/or resume is submitted. Please refer to “Your Application” in your account to check the status of your application for this position.
A successful fingerprint-based criminal history check, drug screen, and reference checks are required for the selected candidate for this position. Under Virginia Code §37.2-314 and 37.2-408.1, the Department of Behavioral Health and Developmental Services is prohibited from employing or using as volunteers, persons who have been convicted of specific “barrier” crimes or persons who may be the subject of pending “barrier” charges.
Employees may be required to disclose immunization status for purposes of infection prevention and/or management of outbreaks. Upon acceptance of a job offer, new recruits will be asked to disclose their vaccination status (and for those fully vaccinated, proof of vaccination) during the pre-employment process. If you have any questions, contact the Office of Human Resources.
Commonwealth’s Alternate Hiring Process: In support of the Commonwealth’s commitment to inclusion, individuals with disabilities are encouraged to apply through the Commonwealth Alternative Hiring Process. To be considered for this opportunity, applicants will need to provide their Certificate of Disability (COD) provided by a Certified Rehabilitation Counselor with the Department of Aging and Rehabilitative Services (DARS). Veterans are encouraged to answer Veteran status questions and submit their disability documentation, if applicable, to DARS, to get their Certificate of Disability. To obtain a Certificate of Disability go to: https://www.vadars.org/drs/cpid/PWContact.aspx, or call DARS at 800-552-5019. Reasonable accommodations are available to persons with disabilities during the application and/or interview process per the Americans with Disabilities Act. Contact Human Resources at (434) 773-4208 for assistance.
DBHDS is an equal Opportunity Employer. Employment opportunities are open to all regardless of race, sex, color, national origin, religion, sexual orientation, gender identity, age, veteran status, political affiliation, genetics, or disability. Minorities, Individuals with Disabilities, Veterans, and people with National Service experience are encouraged to apply. EEO/AA/TTY.
SVMHI uses Form I-9 and E-Verify in the verification of eligibility for employment.
SVMHI is a smoke and vape-free facility in all buildings and outside facility grounds.
Contact Information
Name: Human Resources
Phone: 434-421-3060
Email: svmhihr@dbhds.virginia.gov
In support of the Commonwealth’s commitment to inclusion, we are encouraging individuals with disabilities to apply through the Commonwealth Alternative Hiring Process. To be considered for this opportunity, applicants will need to provide their AHP Letter (formerly COD) provided by the Department for Aging & Rehabilitative Services (DARS), or the Department for the Blind & Vision Impaired (DBVI). Service-Connected Veterans are encouraged to answer Veteran status questions and submit their disability documentation, if applicable, to DARS/DBVI to get their AHP Letter. Requesting an AHP Letter can be found at AHP Letter or by calling DARS at 800-552-5019.
Note Applicants who received a Certificate of Disability from DARS or DBVI dated between April 1, 2022- February 29, 2024, can still use that COD as applicable documentation for the Alternative Hiring Process.
The Commonwealth of Virginia is located in the South Atlantic region of the United States. It was the 10th state to be admitted to the Union on June 25, 1788. Home to approximately 8 million residents, Virginia is the 12th most populous state in the United States. The capital is Richmond, and its most populous city is Virginia Beach.
The narrative history of the Commonwealth of Virginia often begins with the founding of Jamestown in 1607, near what is now modern day Williamsburg, Virginia. Jamestown became the first permanent English settlement in the New World, and the Virginia General Assembly, established on July 30, 1619, is now recognized as the oldest legislative body in the western hemisphere. When Virginia became a royal colony in 1624, the robust tobacco trade that had been developing in Virginia helped establish the American colonies as a powerful economic force. During the American Revolution, Virginia witnessed the final surrender of British forces at Yorktown and later became known as the birthplace of many revolution-era figures and future American presidents, including George Washington and Thomas Jefferson. To date, 8 United States presidents have been born in Virginia, more than in any other state.
The modern government of Virginia is nearly identical in structure to the federal government, and is divided into 3 branches, these being the executive, legislative, and judiciary branches. The Virginia General Assembly is comprised of the 100-member House of Delegates and the 40-member Senate. A governor and lieutenant governor are elected every 4 years. Governors cannot be elected to or serve consecutive terms. Virginia’s judicial system consists of the Supreme Court of Virginia and the Court of Appeals of Virginia, the Circuit Courts, and the lower General District Courts and the Juvenile and Domestic Relations District Courts. Virginia has 13 electoral votes in presidential elections, and possesses 11 seats in the U.S. House of Representatives.
