The posting
About the Role: The Compliance Investigator provides internal review of all incidents, complaints, and allegations of compliance violations within the context of relevant behavioral health industry standards and regulations. They conduct routine and full investigations, as needed, ensuring adherence to confidentiality and sensitivity standards. The Compliance Investigator collects evidence using a variety of methods, including but not limited to interviews, statement collection, review of video footage, and documentation review. At the conclusion of all cases, the Compliance Investigator initiates written findings and recommendations in alignment with organizational compliance standards.
The Compliance Investigator provides internal review of all incidents, complaints, and allegations of compliance violations within the context of relevant behavioral health industry standards and regulations. They conduct routine and full investigations, as needed, ensuring adherence to confidentiality and sensitivity standards. The Compliance Investigator collects evidence using a variety of methods, including but not limited to interviews, statement collection, review of video footage, and documentation review. At the conclusion of all cases, the Compliance Investigator initiates written findings and recommendations in alignment with organizational compliance standards.
DUTIES & RESPONSIBILITIES:
Review and Report Critical Incidents
Conduct same-day reviews of all incoming incident reports.
Request clarifying information from submitting parties to triage the case for external reporting or internal investigation.
Submit all externally reportable incidents to the appropriate agencies based on the agency-specific reporting timeframes and formats, ensuring compliance with HIPAA and other relevant regulations.
Review agency email and external portals for requests for additional information from external parties.
Review Incoming Complaints and Allegations of Compliance Violations
In consult with the Compliance Officer:
Review all complaints and allegations of compliance violations, ensuring adherence to confidentiality protocols.
Request clarifying information from submitting parties to triage the case effectively.
Conduct Internal Investigations
Complete thorough, objective reviews of all assigned cases within specified the timeframes and compliance standards as outlined in the policy.
Conduct interviews, collect written statements, and conduct onsite visits, as needed to investigate incidents and allegations, maintaining sensitivity to behavioral health contexts.
Utilize technology to capture digital artifacts and leverage other resources to gather evidence while maintaining data security.
Communicate barriers to completing investigations in a timely manner.
Complete all required documentation fully and in a timely manner.
Properly document all complaints and alleged violations with the appropriate software, ensuring data integrity and confidentiality.
Submit written reports on the approved template for all reviews and investigations, adhering to organizational reporting standards.
Submit monthly reports of opened and closed cases for the assigned caseload, emphasizing compliance metrics.
Assist with External Investigations.
In consultation:
Coordinate with external agencies on incident investigations, ensuring collaborative and compliant interactions.
Collaborate with internal stakeholders, as needed, to assist with external investigations upholding confidentiality standards.
Assists with special projects as assigned.
Conducts debriefs of sentinel events ensuring organizational learning and improvement.
Provides training and/or technical assistance around reporting protocols emphasizing compliance with industry standards.
Assists with division projects, as needed, demonstrating adaptability and initiative.
Engages in ongoing professional development and maintains role-specific certifications.
Maintain role-specific certifications and engage in continuous professional development to stay abreast of regulatory changes and investigative best practices.
Perform other duties as assigned.
NEEDED ATTRIBUTES: This position provides critical reviews of incidents, allegations, and violations and provides recommendations based on policy. The ideal candidate will possess critical thinking and problem-solving skills. The ideal candidate will be able to work independently and be driven to meet strict deadlines. The ability to write clearly and communicate in a clear and understandable manner is a must.
QUALIFICATIONS:
Certification or training as an investigator; A minimum of three years in law enforcement or as an investigator in another setting is strongly preferred.
WORKING CONDITIONS: The job is routinely 8:15 a.m. to 5:00 p.m. in an office setting; After hours and weekend work and local travel may be required to fully investigate some cases. This position may be eligible for consideration for a hybrid work arrangement under the telework policy.
Pre-employment drug screening may be required. Selected applicant will be subject of an FBI Criminal History Record Check, and the applicant has the right to challenge the contents of their Criminal History Record Information, should they choose to do so. This employer participates in E-Verify.
