<p>Ensures clinical services comply with federal, state, and local regulations, as well as internal policies. Focuses on maintaining compliance with laws including Health Insurance Portability and Accountability Act (HIPAA), Medicaid, and other health related mandates. Oversees audits, compliance policies and provides training for staff.</p> <p>Major Duties</p> <ul> <li>Ensures department adherence to confidentiality, ethical standard, and risk management protocols. Conducts audits of documentation, coding, billing practices and payer contracts to ensure regulatory compliance. </li><li>Leads accreditation processes, ensuring department maintains compliance with accrediting bodies. </li><li>Trains staff on HIPAA, 42 CRF Part 2, Medicaid regulations, and fraud prevention measures. </li><li>Maintains knowledge related to industry regulations and standards to ensure policies align with best practices. </li><li>Provides compliance training to staff. </li><li>Collaborates with University teams and external providers to address compliance issues. Serves as a liaison between University clinics and regulatory agencies. </li><li>Manages data collection, reporting and program evaluations to meet mandated requirements. </li><li>Manages the credentialing processes for relevant payer contracts. </li><li>Develops and implements annual improvement plans for department in collaboration with University leadership and department directors. </li></ul> <p>Minimum Qualifications</p> <ul> <li>Bachelor's degree in a related field from an accredited institution. </li><li>Two years' relevant experience. </li><li>Experience in healthcare compliance, behavioral health regulations and privacy laws. </li><li>Experience with analytical skills for data review and reporting. </li><li>Experience in communication skills, training and collaboration. </li></ul> <p>Desired Qualifications Special Instructions to Applicants</p> <ul> <li>External applicants should use the WMU - Application. </li><li>Internal applicants should use the WMU - Internal Application. </li></ul> <p>Additional Position Information</p> <ul> <li>Terminal Appointment ends 06/30/2026 with a potential of being extended. </li><li>Staff Compensation System pay grades and rates are available at: https://wmich.edu/hr/staffcompensation </li><li>Western Michigan University offers generous benefits to its employees including health, dental, vision, life and disability insurance, retirement, and tuition discount for the employee and tuition remission for eligible dependents. To access information about the specific benefits available for this position, go to: https://www.wmich.edu/hr/enrollment-staff </li></ul> <p>Physical requirements and working conditions</p> <ul> <li>Office or other indoor work with minimal physical demands such as occasionally lifting or moving materials less than 25 pounds. </li><li>Work is generally performed in a well-lit, temperature-controlled indoor environment with occasional exposure to the outdoors or any number of elements. </li></ul>