Who Are WeLotus Behavioral Health Is a Center of Excellence for Adolescents with Family-Focused Care. We are committed to creating a nurturing and therapeutic environment to foster a healthy lifestyle in our clients. At Lotus Behavioral Health, we believe in treating our patients and their families with the respect and high-quality care they deserve. In our teen substance use treatment, active family participation is essential for recovery.
About us:
Click HereLotus Behavioral Health is seeking aWho Are WeLotus Behavioral Health Is a Center of Excellence for Adolescents with Family-Focused Care. We are committed to creating a nurturing and therapeutic environment to foster a healthy lifestyle in our clients. At Lotus Behavioral Health, we believe in treating our patients and their families with the respect and high-quality care they deserve. In our teen substance use treatment, active family participation is essential for recovery.
About us:
Click HereLotus Behavioral Health is seeking a Risk & Compliance Coordinator to support the organization’s commitment to regulatory compliance, quality standards, risk management, and operational excellence. This role is responsible for assisting with compliance monitoring, audits, incident review, policy review and implementation, documentation, employee training, and ongoing adherence to applicable federal, state, licensing, accreditation, and organizational requirements. The ideal candidate is highly organized, detail-oriented, proactive, and capable of identifying potential risks while working collaboratively with leadership and team members to promote a culture of accountability, safety, and continuous improvement.
- Classification: Full-Time, Exempt
- Salary: $50k to 60k annually
- Reports To: Chief Executive Officer (CEO)
- Work Location: Winter Springs, Florida
Benefits for full-time employees only :- Medical
- Dental
- Vision
- Paid Time off (PTO)
- Holidays
- 401K match
Position Summary
- The Risk & Compliance Coordinator is responsible for coordinating and supporting Lotus Behavioral Health's risk management, regulatory compliance, quality assurance, incident management, and patient safety programs. This position works collaboratively with executive leadership, clinical leadership, Human Resources, and department managers to help ensure compliance with all applicable federal, state, and local regulations while promoting a culture of safety, accountability, and continuous quality improvement.
- The Risk & Compliance Coordinator assists in preparing the organization for regulatory surveys, licensing inspections, audits, and accreditation activities while monitoring compliance with applicable behavioral health standards established by the Florida Department of Children and Families (DCF), Florida Agency for Health Care Administration (AHCA), Centers for Medicare & Medicaid Services (CMS), HIPAA, OSHA, Medicare, Medicaid, The Joint Commission and other applicable regulatory and quality agencies.
Essential Duties and Responsibilities
Regulatory Compliance
- Monitor compliance with DCF, AHCA, CMS, Medicare, Medicaid, HIPAA, OSHA, DEA (when applicable), The Joint Comission, and all applicable behavioral health regulations.
- Monitor regulatory changes and communicate operational impacts to leadership.
- Assist with maintaining licenses, permits, certifications, and required regulatory documentation.
- Prepare documentation for surveys, inspections, and audits.
- Coordinate responses to regulatory requests under the direction of executive leadership.
Risk Management
- Coordinate the organization's risk management activities.
- Identify operational, clinical, compliance, financial, and reputational risks.
- Maintain the organizational Risk Register.
- Assist leadership with risk assessments and mitigation strategies.
- Track corrective action plans through completion.
Incident Management
- Oversee the incident reporting process.
- Assist leadership in Investigating employee, patient, visitor, and facility incidents.
- Coordinate Root Cause Analyses (RCA) for significant events.
- Maintain incident logs and reporting metrics.
- Recommend process improvements to reduce future risk.
Patient Safety
- Monitor patient safety trends.
- Help identify issues surrounding patient observation documentation and patient safety rounding.
- Review adverse events, medication errors, abuse allegations, neglect allegations, elopements, suicide attempts, overdoses, restraint and seclusion events, and other reportable incidents.
- Assist leadership with corrective action planning.
- Promote a culture of patient safety throughout the organization.
Quality Assurance & Performance Improvement (QAPI)
- Support the organization's Quality Assurance and Performance Improvement Program.
- Conduct internal compliance audits.
- Monitor Key Performance Indicators (KPIs).
- Track corrective actions.
- Prepare quality reports for leadership meetings.
Clinical Documentation Audits
- Audit clinical records for regulatory compliance and documentation quality.
- Review treatment plans, assessments, progress notes, discharge summaries, and other clinical documentation.
- Identify documentation deficiencies and recommend corrective actions.
HIPAA & Privacy Compliance
- Monitor HIPAA compliance.
- Investigate potential privacy violations.
- Assist with breach investigations.
- Coordinate annual HIPAA education and training.
Internal Auditing
Conduct or coordinate audits involving:
- Clinical documentation
- Personnel records
- Credentialing files
- Infection prevention
- Medication management
- Regulatory compliance
- Policy compliance
- Safety inspections
- Environment of care
- Ligature Risk Mitigation
Emergency Preparedness
- Participate in emergency preparedness planning.
- Coordinate regulatory compliance activities during emergencies.
- Participate in emergency drills and business continuity planning.
Reporting
- Prepare reports regarding:
- Incident trends
- Compliance findings
- Audit results
- Corrective action status
- Patient safety indicators
- Regulatory updates
- Quality improvement initiatives
Required Qualifications
- Bachelor's degree in Healthcare Administration, Nursing, Public Health, Behavioral Health Administration, Healthcare Compliance, Risk Management, or a related field.
- Minimum three (3) years of experience in healthcare, behavioral health, compliance, quality assurance, risk management, or regulatory oversight.
- Working knowledge of DCF, AHCA, CMS, Medicaid, HIPAA, Joint Commission and behavioral healthcare regulations.
- Experience conducting investigations, audits, and compliance reviews.
- Strong analytical, organizational, and communication skills.
- Proficiency in Microsoft Office and electronic health record systems.
Preferred Qualifications
- Master's degree in a related field.
- Certified Professional in Healthcare Risk Management (CPHRM).
- Certified in Healthcare Compliance (CHC).
- Certified Professional in Healthcare Quality (CPHQ).
- Experience working in behavioral health, crisis stabilization, residential treatment, or substance use treatment settings.
Physical Requirements
- Ability to sit, stand, walk, bend, and lift up to 20 pounds.
- Frequent computer and telephone use.
- Ability to travel between company locations as needed.
All individuals applying and/or working at Lotus Behavioral Health are subject to State and Federal Background Screening requirements. For additional information see:
https://crw.flclearinghouse.com/to support the organization’s commitment to regulatory compliance, quality standards, risk management, and operational excellence. This role is responsible for assisting with compliance monitoring, audits, incident review, policy review and implementation, documentation, employee training, and ongoing adherence to applicable federal, state, licensing, accreditation, and organizational requirements. The ideal candidate is highly organized, detail-oriented, proactive, and capable of identifying potential risks while working collaboratively with leadership and team members to promote a culture of accountability, safety, and continuous improvement.
- Classification: Full-Time, Exempt
- Salary: $50k to 60k annually
- Reports To: Chief Executive Officer (CEO)
- Work Location: Winter Springs, Florida
Benefits for full-time employees only :- Medical
- Dental
- Vision
- Paid Time off (PTO)
- Holidays
- 401K match
Position Summary
- The Risk & Compliance Coordinator is responsible for coordinating and supporting Lotus Behavioral Health's risk management, regulatory compliance, quality assurance, incident management, and patient safety programs. This position works collaboratively with executive leadership, clinical leadership, Human Resources, and department managers to help ensure compliance with all applicable federal, state, and local regulations while promoting a culture of safety, accountability, and continuous quality improvement.
- The Risk & Compliance Coordinator assists in preparing the organization for regulatory surveys, licensing inspections, audits, and accreditation activities while monitoring compliance with applicable behavioral health standards established by the Florida Department of Children and Families (DCF), Florida Agency for Health Care Administration (AHCA), Centers for Medicare & Medicaid Services (CMS), HIPAA, OSHA, Medicare, Medicaid, The Joint Commission and other applicable regulatory and quality agencies.
Essential Duties and Responsibilities
Regulatory Compliance
- Monitor compliance with DCF, AHCA, CMS, Medicare, Medicaid, HIPAA, OSHA, DEA (when applicable), The Joint Comission, and all applicable behavioral health regulations.
- Monitor regulatory changes and communicate operational impacts to leadership.
- Assist with maintaining licenses, permits, certifications, and required regulatory documentation.
- Prepare documentation for surveys, inspections, and audits.
- Coordinate responses to regulatory requests under the direction of executive leadership.
Risk Management
- Coordinate the organization's risk management activities.
- Identify operational, clinical, compliance, financial, and reputational risks.
- Maintain the organizational Risk Register.
- Assist leadership with risk assessments and mitigation strategies.
- Track corrective action plans through completion.
Incident Management
- Oversee the incident reporting process.
- Assist leadership in Investigating employee, patient, visitor, and facility incidents.
- Coordinate Root Cause Analyses (RCA) for significant events.
- Maintain incident logs and reporting metrics.
- Recommend process improvements to reduce future risk.
Patient Safety
- Monitor patient safety trends.
- Help identify issues surrounding patient observation documentation and patient safety rounding.
- Review adverse events, medication errors, abuse allegations, neglect allegations, elopements, suicide attempts, overdoses, restraint and seclusion events, and other reportable incidents.
- Assist leadership with corrective action planning.
- Promote a culture of patient safety throughout the organization.
Quality Assurance & Performance Improvement (QAPI)
- Support the organization's Quality Assurance and Performance Improvement Program.
- Conduct internal compliance audits.
- Monitor Key Performance Indicators (KPIs).
- Track corrective actions.
- Prepare quality reports for leadership meetings.
Clinical Documentation Audits
- Audit clinical records for regulatory compliance and documentation quality.
- Review treatment plans, assessments, progress notes, discharge summaries, and other clinical documentation.
- Identify documentation deficiencies and recommend corrective actions.
HIPAA & Privacy Compliance
- Monitor HIPAA compliance.
- Investigate potential privacy violations.
- Assist with breach investigations.
- Coordinate annual HIPAA education and training.
Internal Auditing
Conduct or coordinate audits involving:
- Clinical documentation
- Personnel records
- Credentialing files
- Infection prevention
- Medication management
- Regulatory compliance
- Policy compliance
- Safety inspections
- Environment of care
- Ligature Risk Mitigation
Emergency Preparedness
- Participate in emergency preparedness planning.
- Coordinate regulatory compliance activities during emergencies.
- Participate in emergency drills and business continuity planning.
Reporting
- Prepare reports regarding:
- Incident trends
- Compliance findings
- Audit results
- Corrective action status
- Patient safety indicators
- Regulatory updates
- Quality improvement initiatives
Required Qualifications
- Bachelor's degree in Healthcare Administration, Nursing, Public Health, Behavioral Health Administration, Healthcare Compliance, Risk Management, or a related field.
- Minimum three (3) years of experience in healthcare, behavioral health, compliance, quality assurance, risk management, or regulatory oversight.
- Working knowledge of DCF, AHCA, CMS, Medicaid, HIPAA, Joint Commission and behavioral healthcare regulations.
- Experience conducting investigations, audits, and compliance reviews.
- Strong analytical, organizational, and communication skills.
- Proficiency in Microsoft Office and electronic health record systems.
Preferred Qualifications
- Master's degree in a related field.
- Certified Professional in Healthcare Risk Management (CPHRM).
- Certified in Healthcare Compliance (CHC).
- Certified Professional in Healthcare Quality (CPHQ).
- Experience working in behavioral health, crisis stabilization, residential treatment, or substance use treatment settings.
Physical Requirements
- Ability to sit, stand, walk, bend, and lift up to 20 pounds.
- Frequent computer and telephone use.
- Ability to travel between company locations as needed.
All individuals applying and/or working at Lotus Behavioral Health are subject to State and Federal Background Screening requirements. For additional information see:
https://crw.flclearinghouse.com/