Job Details

Job Location Achieva Main Office - Pittsburgh, PAPosition Type Full Time

Additional Job Details:

Department: Compliance
Reports To: President of Achieva Support
FLSA Status: Exempt
Salary: $85,000
Work Schedule: Full-Time, 37.5 hours per week

Make a Meaningful Impact

Are you a mission-driven individual looking to make a difference in someone’s life? Achieva is seeking caring, compassionate, and reliable individuals to support people with disabilities in achieving independence, connection, and personal fulfillment. If you value flexibility, empowerment, and community-centered work, we welcome you to apply.

About Achieva

For over 70 years, Achieva has been committed to supporting and including individuals with disabilities and their families. We envision a community where everyone leads a life of personal significance. Achieva provides personalized services and opportunities that respect each person’s unique aspirations.

Position Summary

This position will ensure Achieva Support programs are in compliance with long-term support and services government laws, regulations, funders, and agency standards. Responsible for developing and maintaining Achieva Support program policies and procedures to ensure compliance to mandates. Oversees Achieva Support's Clinical Team, Training Team, and is responsible for Achieva Support's Incident Management and Quality Assurance processes. Facilitates annual state quality assessment improvement (QAI) audits. Participates and provides support to Achieva Support annual state licensing and private funder audits. The Quality and Compliance Vice President will be knowledgeable about all government and industry regulations and will identify regulations that are not being adhered to and will advise appropriate leadership. The Vice President of Quality and Compliance Management will directly report to the President and Senior Vice President of Achieva Support.

Key Responsibilities

Immediate supervisor, implement the approved plan or strategy, and provide continuous monitoring and updates to the plan as directed by the immediate supervisor
Ensure the organization’s compliance with all external regulations related to performance and quality improvement including, but not limited to, Health Insurance Portability and Accountability Act (HIPAA), Office of Developmental Programs (ODP), Occupational Safety and Health Administration (OSHA), Office of Child Development and Early Learning (OCDEL) and Center for Medicare and Medicaid Services (CMS). Lead's Community Supported Living's Performance-Based Contracting activities
Plans, coordinates, and directs quality initiatives designed to ensure quality control and quality assurance of program services consistent with established standards
Use metrics to provide support in linking projects to strategic operational objectives
Develops initiates, maintains, and revises policies and procedures for program offices to ensure compliance with applicable rules and statutes and with the goal of promoting consistency across Achieva Support departments to the extent appropriate and practicable
Maintains current working knowledge of Federal and State regulations and policies as they affect through routine review of various standards (such as Pennsylvania Code, Bulletins, etc.), Federal Register notices, applicable government and/or industry related internet information sites, multiple stated Medicaid manuals, and multiple State and Local regulations
Mentors executive/program leaderships' understanding/knowledge of key government and funder regulations and communications. Provides guidance and training to employees on compliance-related matters
Oversees and facilitates annual state quality, assessment, improvement (QAI) audits, collaborating with Achieva and Achieva Support program departments as needed
Provides government and/or funder monitoring/inspection support to Achieva Support program offices as needed
Develops and implements audit corrective action plans as needed
Collaborates with other departments (e.g. Human Resources, Finance, etc.) to direct compliance issues to appropriate management for investigation and resolution
Identify organizational and/or program strengths and weaknesses, develops recommendations for approval
Provides reports on a regular basis, and as directed or requested, to keep senior management informed of the operations and progress of compliance efforts
Works in conjunction with Achieva's Compliance Team to ensure Achieva Support policies align with Achieva's Family of Organizations policies and mandates
Collaborates, and interprets key points, for/with Achieva departments (e.g. Information Systems, Finance, etc.) on critical policy reviews, and updates Achieva/Achieva Resource/Achieva Support policies as requested that affect multiple corporate areas
Acts as an independent review and evaluation body to identify compliance issues/concerns within the Achieva Support organization are being appropriately evaluated and resolved
Analyzes government and/or public policy and alert the organization to trends and risks
Oversees Achieva Support's Incident Management operations; implementing corrective action plans and conducting root cause analysis for trended risks
Secures Pennsylvania quality manager certification; develops and maintains Achieva Support's quality management plan; providing ongoing review and revision as needed
Oversees Achieva Support's Training program and works with Human Resources Department and others as appropriate to develop an effective compliance training program, including appropriate introductory training for new employees as well as ongoing training for all employees and managers
Oversees the Achieva Support credentialing administration process within the Achieva Support Training department
Maintains Achieva Support's service qualification with state offices and private funders working in collaboration with Achieva offices to secure service qualifications
Communicates comments/concerns regarding proposed program policies or impending implementation of program policies to the immediate supervisor
Establishes and provides direction and management of a compliance reporting system, Hotline, or other centralized mechanism for compliance issue reporting
Develop and implement performance improvement initiatives to meet business objectives
Establishes metrics to monitor financial savings as compared to established goals and targets; i.e., utilization etc
Institutes and maintains an effective quality and compliance communication program for the organization, including promoting (a) use of Compliance reporting system Hotline; (b) heightened awareness of Standards of Conduct, and (c) understanding of new and existing compliance issues and related policies and procedures
Represents internal and external committees related to Compliance and quality improvement
Develops, initiates, and maintains effective programs for workforce retention, promotion, and succession planning within the Quality/Compliance program. Identifies, assesses, and develops successors and/or identifies the need for potential external candidates to succeed themself and direct reports. Be dedicated to the development of successors and people who have the potential for further responsibility. Ensures plans are in place for short-term continued operations. Identifies work assignments for further learning and development of employees. Reviews and updates the succession plan annually
Performs other related duties as assigned. This job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities that are required of the employee for this internship. Duties, responsibilities, and activities may change at any time with or without notice

Qualifications

Seven plus years industry related experience in health and human services (BA/BS –or-four years industry related experience in health and human services (MA/MS)
A Background in Title XIX Medicaid and Medicare regulations and reimbursement, and a basic understanding of fraud and abuse rules and neglect abuse rules
Excellent interpersonal, analytical and leadership skills necessary, plus demonstrated ability to work with a wide variety of constituent groups
Familiarity with the operation, financial, quality assurance, human resources procedures, and regulations required
Knowledge of best practices in the field of community support for people with disabilities
Requires sound reasoning, good judgment, and decision-making skills
Must meet ACT 33/34 requirements
Valid Pennsylvania driver’s license and vehicle available for work required

Work Environment & Requirements

Hybrid or remote work flexibility may be available based on organizational needs

Why Join Achieva?

Meaningful Work: Directly contribute to the lives of people with disabilities
Inclusive Culture: Be part of a values-driven, supportive team
Comprehensive Benefits Include:

Health, Dental, and Vision Insurance with low employee contributions
Company-Paid Life, AD&D, and Long-Term Disability Insurance
403(b) Retirement Plan with employer contributions after one year
Employee Assistance Program for personal and family support
Generous Paid Time Off and Holidays for work-life balance

Our Commitment to Inclusion

Achieva is an Equal Opportunity Employer (EOE) and is committed to creating a workplace and community where all individuals feel respected, included, and valued. All qualified applicants will receive consideration without regard to race, color, religion, sex, age, disability, sexual orientation, gender identity or expression, national origin, veteran status, or genetic information.

We are dedicated to providing access, equal opportunity, and reasonable accommodations for individuals with disabilities in employment, programs, and activities. To request an accommodation, contact Human Resources at 412-995-5000 ext. 650 or hrsupport@achieva.info.