Compliance Specialist

Compliance Specialist                                                                                  

About Impact Health

Impact Health is an Asheville-based nonprofit leading Western North Carolina’s participation in North Carolina’s Healthy Opportunities Pilot. HOP is a groundbreaking initiative that uses Medicaid funding to support social drivers of health across four key domains: food, housing, transportation, and interpersonal safety and toxic stress. The pilot’s aim is to improve health outcomes for NC Medicaid members who could benefit most while reducing overall healthcare costs.  

Impact Health supports a network of more than 50 human service organizations (HSOs) by:  

• Serving as a bridge between the state, private health plans, care managers and other HSOs.  
• Building organizational capacity through financial support, training, and technical assistance.  
• Assisting with Medicaid billing, data collection and evaluation efforts.   
• Convening pilot entities to share best practices.  

Impact Health is committed to improving the wellbeing of all those living in WNC by connecting community-based organizations and healthcare systems to ensure equitable, inclusive whole-person care.  

Summary

The Compliance Specialist will support the Compliance Manager in monitoring internal compliance at Impact Health and external partners, such as HSOs providing services. The Compliance Specialist will ensure compliance with the contractual obligations of the Health Opportunities Pilot Program.

Responsibilities 

• Assist the Compliance Manager, Associate Director of Programs, and Quality Improvement and Program Evaluation Manager with ongoing and targeted compliance assessments of pilot stakeholders, including Impact Health, PHPS, Care Managers, subcontractors, and HSOs. Compliance assessments might be remote (desktop / documentation review) or on-site, as needed, in accordance with the contractual obligations of the Pilot.
• Assist Operations Team members in gathering and filing any supporting documentation that is required for Pilot integrity, including gathering content for standard reporting and contractual requirements, as well as documentation required for fraud, waste, and abuse investigations.
• Assist the Compliance Manager and Associate Director of Programs in identifying, documenting, and correcting issues related to compliance in our Network. 
• As requested, provide additional compliance-related technical assistance or training to Pilot Stakeholders on compliance.
• Provide support with monitoring, reviewing, and tracking the data from Pilot stakeholders, such as HOP clients, care managers, HSOs. 
• Track and document HSOs and Impact Health’s employees, Board of Directors, and subcontracts Conflict of Interest.
• Identify areas of risk and/or weakness in internal Impact Health compliance program based on analysis performed and make recommendations for improvement to Compliance Lead.
• Develop and present formal written reports to communicate monitoring and complaint results to management.
• Works closely with the Programs, Accounting, and Quality Improvement in the development of HSO contract reviews, reports and processes for measuring, tracking, and analyzing outcomes.
• Assist the Compliance Manager and Quality Improvement and Program Evaluation Manager in delivering the annual HSO Monitoring and Oversight Plan.
• Compile documents, maintain up-to-date files and records related to compliance.
• Maintain familiarity with applicable laws, statues, code, policy and contractual requirements.

Qualifications

Qualifications are a guiding light and not all encompassing of what Impact Health considers throughout the selection process. We encourage all candidates to include a cover letter to share how their lived experience, education, and work experience combine to support this role. 

• Associate degree in Social Work, Public Administration, or closely related field.
  • Bachelor’s degree preferred.
• 2 years’ experience in contract compliance or the development and administering of agency procedures and contracts; OR 2 years’ progressive responsibility in a front-line or supervisory role within a human service-focused setting and/or exposure to performance management.
• Knowledge of human service provider networks preferred.
• Non-Profit Experience Preferred
• Commitment to Health Equity.
• Ability to manage priorities and meet deadlines.
• Strong organizational skills and time management.
• Excellent attention to detail and follow through.
• Ability to handle confidential information in a professional manner.
• Ability to follow up on action items independently while meeting deadlines.
• Ability to identify the distinction between human errors in unreliable systems and intentional acts. 
• Evidence of being a team player and supportive colleague with strong interpersonal skills. 
• Ability to work in a high-pressure, fast-paced environment.
• Ability to be flexible with direction changes and solve problems.
• Effective communication skills, written and spoken.
• Demonstrate and lead with empathy and compassion.
• Bring a working understanding around culture competence and a desire to grow in this skill. 
• Align with a collaborative approach and accountability practices.

Essential Physical Skills

Possess the physical health and stamina to consistently carry out job duties and essential functions over a workday. Ability to operate a motor vehicle and meet Impact Health standards for acceptable driving record.

Working Conditions

The position is hybrid with frequent visits to external environments that require driving to and from various locations including the office as needed. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the position. Team members of Impact Health must live within the 18-county region we serve.  

Compensation and Benefits

Salary starting at $52,000 to $58,000 yearly.

Starting salary is commensurate with experience that will be vetted through the interview process.

All full-time team members can take part in a broad offering of competitive benefits, including health insurance, retirement, PTO, and more.

Impact Health’s Commitment to Equity and Inclusion

Impact Health is committed to diversity, equity, and inclusion in our work and on our teams. We know that the rich diversity of perspectives and wisdom that is imperative to our purpose can only come from a wide variety of origins and life experiences. We strongly believe that creating a workplace where all team members thrive is critical to fulfilling our purpose in the communities we serve and we intentionally recruit, develop, and retain the most talented people from a diverse candidate pool.  

Qualified candidates are urged to apply and will receive consideration for employment without regard to race, color, ethnicity, sex, age, national origin, religion, sexual orientation, gender identity and/or expression, status as a veteran, and basis of disability or any other federal, state, or local protected class.  

In addition, we value having a team that is embedded, and living, throughout the 18 counties we serve. Applicants that live outside of Buncombe County are strongly encouraged to apply.