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Compliance Monitor

Community Behavioral Health

This is a Full-time position in Philadelphia, PA posted October 26, 2021.

Position Overview: 

The Internal Compliance Auditor works directly with the Director of Internal Compliance and Risk Management and will drive internal audit activities including development of audit plans, conducting audits and working with department on remediation plans. The Internal Compliance Auditor will also, assist with training and education, and overall efforts to enhance a culture of compliance at CBH.  

Essential Functions

  • This position will strengthen CBH’s Internal Compliance and Risk Management program by supporting the agency’s risk assessment and risk management activities including: 
    • Partnering with leaders and teams to ensure agency policies and operational procedures are current, accurate, and appropriately implemented.
    • Preparing and delivering internal compliance and risk management trainings. 
    • Possesses the ability to research regulatory guidelines to respond to questions from Officers and department management.
    • Oversight of required monthly exclusion checks.  
    • Assist in identifying, investigating, and documenting HIPAA breaches.  
    • Design audit objectives and procedures for scheduled and unscheduled internal audits, reviews and special projects as assigned.
      1. Draft audit workplans, audit tools and audit reports
  1. Communicate audit findings to audited departments and senior leadership to ensure the audited entity’s understanding of the matters identified.   
  2. Aid in the development of corrective action plans to ensure compliance with regulatory bodies.  

Position Requirements: 

  • Education: Master’s degree preferred.  Bachelor’s degree required.   
  • Certification in Healthcare Compliance and/or Certified Internal Auditor highly desirable  or obtained within one year of employment.  
  • 3+ years’ experience with Managed Care organization or health plans or 3+ years’ experience in health care compliance auditing and monitoring.  
  • Proof of COVID vaccination required
  • Skills:
  • High level proficiency with Microsoft Office applications
  • Excellent written and verbal communication skills
  • High comfort level with public speaking and training
  • Knowledge of Medicaid regulations and requirements
  • Demonstrated significant compliance and/or quality assurance experience in a healthcare organization or consultancy firm supporting healthcare clients
  • Detail-oriented and highly organized
  • Ability to work effectively with all levels of staff
  • Ability to manage ongoing projects and prioritize appropriately to meet deadlines

Equal Employment Opportunity: CBH provides equal employment opportunities to all qualified individuals without regard to race, creed, color, religion, national origin, age, sex, marital status, gender identity, sexual orientation, individual genetic information or non-disqualifying physical or mental handicap or disability in each aspect of the human resources function.

Americans with Disabilities Act: Applicants as well as employees who are or become disabled must be able to perform the essential job functions either unaided or with reasonable accommodation.   CBH will determine reasonable accommodation on a case-by-case basis in accordance with applicable law. 

This job profile reflects management’s assignment of current duties, responsibilities, and essential functions; it does not prescribe all or restrict the tasks that may be assigned now, or in the future, relevant to the responsibilities for this position.  Community Behavioral Health (CBH) may change the specific job duties with or without prior notice based on the needs of the organization.