We are seeking an experienced, detail-oriented Compliance Manager to lead compliance monitoring, quality assurance activities, state outcome reporting, and accreditation readiness efforts within our behavioral health organization. This role is responsible for ensuring clinical documentation, reporting processes, and program operations meet state regulations, CARF standards, and evidence-based practice requirements.
The Compliance Manager will work closely with the Quality Management Director, provide oversight of QA support staff, analyze organizational performance trends, and help drive continuous quality improvement across programs.
Key Responsibilities
State Outcomes & Data Reporting (NC TOPPS)
- Manage the organization's end-to-end NC TOPPS submission process.
- Track and monitor due dates for initial, update, and discharge interviews.
- Provide weekly compliance notifications and reminders to clinical teams.
- Generate compliance reports and retrieve data from the NC TOPPS portal.
- Monitor organizational performance against state compliance benchmarks.
- Aggregate and analyze Quality of Care data and safety metrics for leadership review and Quality Management Board reporting.
- Identify trends and assist leadership in implementing corrective actions and process improvements.
Program Fidelity & CARF Readiness
- Complete quarterly fidelity monitoring reviews to evaluate the implementation of Evidence-Based Practices (EBPs).
- Conduct clinical record reviews using established fidelity tools and scoring rubrics.
- Assist with CARF survey preparation by organizing, compiling, and maintaining compliance documentation.
- Monitor Crisis Phone compliance to ensure adherence to state regulations and response protocols.
- Support ongoing accreditation readiness efforts through continuous monitoring and documentation management.
Workflow Management & Staff Oversight
- Provide direct supervision and daily support to Quality Assurance support staff.
- Manage routine auditing workflows to ensure timely and accurate completion of audits.
- Review escalated documentation concerns identified during audits.
- Collaborate with clinical leadership to address documentation deficiencies and corrective actions.
- Oversee the maintenance and accuracy of incident reporting systems and tracking databases.
Medical Records & Administrative Compliance
- Oversee medical records requests and Release of Information (ROI) processes.
- Ensure compliance with HIPAA regulations and timely processing of records requests.
- Support insurance payer audits by coordinating and pulling requested charts and documentation.
- Assist with preparation and organization of audit-related materials.
Required Qualifications
- Master's degree in Social Work, Counseling, Psychology, Healthcare Administration, Public Health, Human Services, or a related field.
- Experience in healthcare compliance, quality management, behavioral health, or clinical operations.
- Strong knowledge of clinical documentation standards, regulatory compliance requirements, and quality assurance processes.
- Experience with NC TOPPS reporting and/or other state reporting systems.
- Proficiency with Microsoft Excel, Electronic Health Records (EHRs), and data reporting systems.
- Strong analytical, organizational, and problem-solving skills.
- Demonstrated leadership and staff supervision experience.
- Excellent verbal, written, and interpersonal communication skills.
Preferred Qualifications
- Current North Carolina licensure as a Licensed Clinical Social Worker (LCSW) or Licensed Clinical Mental Health Counselor (LCMHC).
- Experience with CARF accreditation standards and survey preparation.
- Experience conducting clinical audits, chart reviews, and fidelity monitoring.
- Background in behavioral health, substance use treatment, or community-based healthcare services.
- Experience supervising quality assurance or clinical support staff.
What We're Looking For
The ideal candidate is a highly organized professional who thrives on data analysis, regulatory compliance, quality improvement, and ensuring excellence in clinical practice. This individual will be proactive, collaborative, and committed to supporting high-quality behavioral healthcare services.
Pay: From $65,000.00 per year
Benefits:
- Dental insurance
- Health insurance
- Life insurance
- Loan forgiveness
- Paid time off
- Vision insurance
Work Location: In person
