Clinical Compliance Coordinator

Essential Functions

• Conduct clinical chart reviews, compliance spot checks, and peer reviews of DAs, DAUs, treatment plans, progress notes, and other documentation to ensure quality, medical necessity, and regulatory compliance.

• Identify documentation deficiencies, recommend corrective actions, and provide staff coaching and training on clinical compliance expectations.

• Coordinate agency Quality Improvement (QI) activities, monitor performance indicators, analyze trends, and identify opportunities for improvement.

• Oversee ADAMH outcome measures (BAM, OQ), staff training, and ADAMH, NCCC client satisfaction, and referral source surveys.

• Prepare quarterly Quality Improvement Plan (QIP) reports for the Board of Directors, including agency outcomes, performance measures, incident trends, client satisfaction, compliance activities, progress toward goals, and recommendations.

• Monitor regulatory changes and coordinate updates to agency policies and procedures to maintain compliance with applicable laws, Medicaid, ADAMH, CARF, and other requirements.

• Coordinate Ohio Department of Behavioral Health (DBH/OhioMHAS) licensing and renewals, including Terminal Distributor of Dangerous Drugs (TDDD) renewals and related documentation.

• Coordinate ongoing CARF accreditation readiness, annual survey preparation, compliance reviews, and corrective actions.

• Participate in Corporate Compliance Committee meetings and coordinate quarterly compliance training and other required staff education.

• Coordinate monthly Safety Committee meetings, health and safety activities, site and residential house self-inspections, and related corrective actions.

• Monitor incident reporting, required follow-up communications, regulatory compliance, and trend analysis; identify risks and recommend improvements.

• Lead internal investigations involving compliance, documentation, policy violations, privacy, and quality-of-care concerns, including interviews, record reviews, findings, and recommendations.

• Coordinate the annual review, evaluation, and updating of agency plans with department leadership, ensuring regulatory and CARF compliance, appropriate approvals, and documentation. Plans include: Disaster Preparedness and Emergency Response, Quality Improvement, Information Technology, Professional Services, Cultural Competency and Diversity, Accessibility, Corporate Compliance. Risk Management, Personnel.

• Support HIPAA Privacy compliance, including staff education, communication, privacy concerns, and appropriate follow-up.

• Review subpoenas and legal records requests and coordinate records releases in accordance with applicable laws and agency policy, consulting leadership or legal counsel as needed.

Limited Direct Clinical Services

• Complete Diagnostic Assessments (DA), Diagnostic Assessment Updates (DAU), annual clinical assessments, and required documentation as needed.

• Provide limited direct clinical services to support operational needs while maintaining applicable clinical and documentation standards.

• Serve as a resource to staff and leadership while maintaining the independence and objectivity necessary to effectively monitor organizational compliance and quality.

Minimum Qualifications

• Current, unrestricted Ohio LISW license required.

• Master's degree in Social Work from an accredited program.

• Experience in behavioral healthcare, community mental health, or a related setting.

• Experience with clinical documentation, chart review, compliance, quality assurance, or quality improvement strongly preferred.

• Knowledge of behavioral health documentation and medical necessity requirements.

• Familiarity with Ohio behavioral health regulations, Medicaid requirements, HIPAA, and professional ethical standards.

• Experience with CARF accreditation standards preferred.

• Strong written, analytical, organizational, and verbal communication skills.

• Ability to interpret regulations, standards, policies, and clinical documentation requirements.

• Ability to objectively investigate concerns and communicate findings professionally.

Knowledge, Skills & Abilities

• The successful candidate will demonstrate:

• Knowledge of clinical documentation, behavioral health service standards, compliance monitoring, quality assurance, and continuous quality improvement practices.

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