Who we are:
At Better Life Partners, we provide what it takes to heal from addiction. Wherever. Whenever.
We work alongside community-based organizations to meet our members where they are, no matter what recovery looks like to them. By combining virtual and in-person counseling, community support, and access to life-saving medication, we help people move beyond addiction to find belonging, love, and purpose.
If you’re looking to roll up your sleeves and meet hard challenges head-on, then we’re looking for you.
The role:
We are seeking a Head of Quality and Compliance. In this role you will have oversight of the overall compliance and quality-improvement program for Better Life Partners. You will be accountable for tracking changes in regulations nationally and in our states and ensuring that our policies and procedures are appropriately adherent. You will lead our quality improvement program, helping to identify opportunities and providing oversight for quality improvement plans and execution. You will oversee the process by which we codify our essential policies and procedures.
This is a hybrid position. About 3 days per month, you may be expected to work from our shared workspaces in New York, NY; Boston, MA; Fayetteville, North Carolina, or Manchester, NH. When not in the shared workspaces, you’ll work from home. Candidates must reside in one of the following states: Maine, Maryland, Massachusetts, New Hampshire, New Jersey, New York, North Carolina, Pennsylvania, Rhode Island, Vermont, Connecticut, District of Columbia, Virginia, or Georgia.
What you will do:- Leads the compliance and quality department including developing and maintaining relevant policies and procedures, and resource requirements
- Acts as key point of contact for any and all audits, inspections or investigations relating to grievances, privacy issues, and other compliance issues
- Reviews all contracts and develops auditing instruments based on contractual and regulatory requirements, as well as works closely with Payor Development team to identify incoming requirements
- Conducts regular internal clinical audits of member records, ensuring compliance with all contractual, regulatory and documentation requirements
- Audits programs, policies and procedures, ensuring corporate and programmatic compliance with their contract requirements
- Provides training and education on compliance and other areas as identified through auditing and other quality improvement processes including drafting with appropriate teams any corrective action plans
- Maintains adherence to current regulations and communicates regulatory changes to programs as needed, working with programs on incorporating any identified changes
- Facilitates regular Compliance meetings and participates in other various meetings as necessary
- Collaborates with Key Stakeholders on new program initiatives, helping to ensure compliance with regulatory guidelines as well as payor contracts
- Works with current program and State Leadership on licensing processes, ensuring that contractual, accreditation and regulatory requirements are followed
- Create corrective action plans for detected deficiencies and oversee the completion of plans
- Supervise the Medical Records Department
- Serves as Privacy Officer
- Chair the Policy Committee and oversee the lifecycle of all company policies and procedures
- Additional responsibilities as assigned
You are a good fit if you have:- Previous experience in Payor Clinical Audits, including Medicaid and Medicare
- Prior experience leading audits for a healthcare organization
- A Bachelors degree
- Experience working in a fast-paced environment
- Experience building a compliance and quality infrastructure
It will also be great if you have:- A degree in nursing or another healthcare field
- A masters degree
- Certification in Healthcare Compliance (CHC)
- Experience leading audits and accreditation renewals including but not limited to CARF is strongly preferred
- Experience as a Program Integrity Officer at a plan, managed care organization, or state program preferred
- Worked as an auditor for a payor or healthcare accrediting body
$97,750 - $123,625 a year
The actual compensation offered within the range, along with title and level, will be dependent on a variety of factors including, but not limited to, relevant experience, qualifications, skills, level offered, business requirements, and performance expectations. All full-time BLPeeps are also eligible for equity in the form of stock options to be invested in BLP’s growth and success!
In addition to a competitive compensation package, we’re offering the chance to be the change you wish to see in your community. Help us work toward a future where everyone can have a healthy life filled with belonging, love, and purpose.
We’re a recovery-friendly workplace that values family life, diversity, equity, and inclusion.