Job Description
Description The Compliance and Licensing Officer will serve as a key resource to ensure that all operations, clinical practices and administrative processes at Partners In Excellence adhere strictly to federal, state, and local laws, regulations, and accreditation standards. This includes oversight of licensure compliance, adherence to healthcare laws, privacy regulations, licensing requirements, and insurance guidelines pertinent to ABA, speech, and occupational therapy services. The ideal candidate will develop, monitor, and enforce compliance policies, conduct audits, facilitate ongoing staff education and ensure all employee training is current and fully completed. The position requires close collaboration with Billing, Human Resources, Credentialing, IT, and all clinical teams to promote organization-wide compliance.
Essential Functions - Develop, implement, and regularly update comprehensive compliance policies and procedures tailored to ABA, speech, and occupational therapy practices.
- Ensure organizational practices comply with federal regulations such as HIPAA, OSHA, Medicaid/Medicare requirements, and the Individuals with Disabilities Education Act (IDEA), as applicable.
- Oversee and ensure compliance with all licensing and certification requirements at the state (MN and WI) and federal levels.
- Maintain accountability for licensure renewals and compliance for all clinical and administrative staff, coordinating with licensing boards and collecting required documentation.
- Monitor compliance with all applicable laws including interpretations of state departments (Minnesota Department of Human Services, Wisconsin Department of Health Services) and other relevant regulatory agencies.
- Conduct regular internal audits to assess compliance with clinical documentation standards, billing practices, consent procedures, client privacy protections, and licensure standards.
- Collaborate closely with the Billing Manager and HR Manager to ensure billing practices and employee training meet compliance standards.
- Work with the Credentialing Team to verify and maintain all licensure and credentialing records for clinical staff.
- Coordinate with clinical teams to ensure compliance with clinical standards, documentation, and ethical practices.
- Manage reporting of compliance issues and violations; develop corrective action plans when necessary.
- Serve as a resource for staff regarding compliance issues, ensuring ongoing training and education on regulation updates, ethical standards, and best practices.
- Collaborate with leadership and clinical teams to ensure policies align with best practices and legal requirements
- Ensure all employee training, certifications, and licensure are current and complete. Track training schedules, maintain documentation, and follow up with staff or supervisors when trainings or licensure are overdue or not completed.
- Work directly with supervisors and staff to address non-compliance with required trainings and licensure; coach and implement corrective steps as needed.
- Maintain meticulous documentation of compliance activities, audit findings, incident reports, training and licensure completion records, and corrective actions.
- Stay informed of ongoing regulatory changes at the federal, state, and local levels affecting ABA, speech, and occupational therapy services.
- Foster a culture of compliance, integrity, and continuous quality improvement organization wide.
- Perform regular internal audits on employee and client records to ensure compliance.
- Accountable to develop and lead internal mock surveys and staff preparedness for surveys.
Qualifications Required Education and Experience - Bachelor’s degree in healthcare related field, social work, public health, or a related field.
- Minimum of 3-5 years of experience in healthcare, with specific experience in licensure, credentialing, and credentialing management preferred.
- Deep knowledge of federal laws (HIPAA, Medicaid/Medicare regulations, etc.) and specific state regulations in MN and WI.
- Experience with billing compliance, documentation standards, confidentiality protocols, employee training, and licensure tracking.
- Strong organizational, analytical, and interpersonal skills to collaborate effectively across departments.
- Excellent communication skills with the ability to train, coach, and build relationships with staff and leadership.
- High integrity, attention to detail, and ethical judgment.
Preferred Qualifications - Certifications such as Certified in Healthcare Compliance (CHC), Compliance Certification Board (CCB), or related.
- Experience working in ABA, speech therapy, occupational therapy, or related healthcare fields.
- Familiarity with electronic health records (EHR) and compliance management systems.
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