Administrative Coordinator Compliance/Customer Service

<p><strong>By joining Region 10, you can help actualize our mission of promoting opportunities for recovery, discovery, health and independence for individuals receiving services through ease of access, high quality of care and best value.&nbsp; View the details below on how you can become an Administrative Coordinator Compliance/Customer Service for Region 10 PIHP</strong></p>

Port Huron, MI

Region 10 PIHP

<p>Region 10 Prepaid Inpatient Health Plan Provides public services for mental health and substance use disorders through the Community Mental Health agencies in Genesee, Lapeer, Sanilac and St. Clair counties and a panel of other care providers.</p> <h4>Mission: Promoting opportunities for Recovery, Discovery, Health and Independence for individuals receiving services through ease of access, high quality of care and best value.</h4>

keywords: compliance,support,teamwork,analysis,experience,consulting,knowledge,flexibility,license,degree,transportation,preferred qualifications


$52,700.00 / Year

Overview: <p>An employee at this level is required to perform some or all of the following duties, which do not include all tasks to be performed:</p> <ul> <li>Coordination of designated Customer Service and Corporate Compliance tasks</li> <li>Provide training to staff and contract agencies</li> <li>Contract Monitoring support and Subject Matter Expert</li> <li>Familiarity with Federal Requirements and MDHHS Contract Requirements in areas of Program Integrity and Customer Service</li> </ul>
Responsibilities: <ul> <li>Policy and Procedure Review</li> <li>Report Development</li> <li>Participate in and / or provide support to PIHP Corporate Compliance Committee</li> <li>Corporate Compliance Complaint Review, Investigation and Follow Up</li> <li>OIG Compliance Complaint Referral Review, Investigation and Follow Up</li> <li>Manage Corporate Compliance Hotline</li> <li>Assist with Corporate Compliance Training</li> <li>Primary Source Verification Monitoring</li> <li>Business Associate Agreement Monitoring</li> <li>Provide Support to Grievance &amp; Appeal Manager</li> <li>MDHHS Case Review Inquiry Review and Support</li> <li>Manage Customer Service Handbook</li> <li>Provide support for external site reviews</li> <li>Other tasks as assigned</li> </ul>
Requirements: Minimum Qualifications: (An employee must have the following credentials, training, and experience.)<br /> <ul> <li>Bachelor&rsquo;s Degree in behavioral health field</li> <li>Experience working at Pre-Paid Inpatient Health Plan (PIHP) and / or Community Mental Health (CMH)</li> <li>Experience in the area of Customer Service or Corporate Compliance</li> <li>Basic knowledge of HIPAA Privacy and Security Rules</li> <li>Experience in writing reports, analyzing data and administrative projects</li> <li>Ability to be a &ldquo;work leader&rdquo; (of a person or function), or advise others</li> <li>Experience in managing projects and teams</li> <li>Advanced knowledge of Microsoft Word and Excel</li> <li>Basic knowledge of Microsoft PowerPoint</li> <li>Ability to exercise some flexibility in problem solving, when expected results are clear and generally set by others, provided certain outcomes are avoided</li> <li>Ingenuity is required to adapt, alter or improvise alternatives when unexpected situations occur</li> <li>Ability to exercise discretion and some flexibility in selecting an optimal solution from established alternatives to obtain the desired outcome</li> <li>Ability to use or exert influence in a work process</li> <li>Ability to provide, exchange or explain information which conveys an opinion or evaluation of the facts or analyses</li> <li>Ability to develop and/or maintain effective work relationships with new, established or non-receptive individuals/organizations through tact, diplomacy and persuasion</li> <li>Valid State of Michigan Driver&rsquo;s License</li> <li>Must have access to transportation</li> </ul> <strong>Preferred Qualifications:</strong><br /> <ul> <li>Master&rsquo;s Degree in behavioral health field</li> <li>Experience working at Substance Use Disorder Service Provider and / or CMH subcontract Provider</li> <li>Experience in complaint investigations</li> <li>Knowledge of State of Michigan Medicaid Provider Manual</li> </ul>