Clinical Compliance Contractor
$38 - $46 USD hourly
Job title: Clinical Compliance Contractor
Reports to: Chief Housing Officer
Status of position: Part Time – 20 hours per week, negotiable.
Job Summary:
All Roads has provided homeless services for nearly 40 years. More recently, All Roads has rapidly expanded its impact by partnering with a variety of housing providers and funders in executing Permanent Supportive Housing programing throughout Boulder County. After seeing the success of housing programming in ending homelessness for individuals, All Roads became a housing-focused organization that is committed to leveraging its efforts and resources to effect as many exits from homelessness as possible.
In 2023 and in partnership with the City of Boulder, All Roads developed the Housing Retention Team (HRT), which is a behavioral health team provides in-home clinical services to individuals with histories of chronic homelessness who are either in housing or selected for housing with the goal of easing the transition to housing, promoting housing stability, and address overall behavioral health needs. HRT often supports clients with a high acuity of need resulting to behaviors/symptoms that are a threat to their housing stability and wellbeing.
The Clinical Compliance Contractor will provide temporary coverage during a staff leave, with primary responsibility for Medicaid and clinical compliance, review of Permanent Supportive Housing (PSH) case manager documentation, and rendering-provider oversight for case managers. Depending on organizational needs and the contractor’s availability, the role may also include staff supervision and limited clinical consultation or direct support for clients.
Primary Responsibilities:
Medicaid Compliance and Quality Assurance
- Serve as the primary resource for Medicaid compliance during the contract period and help ensure services meet applicable regulations, payer requirements, and organizational policies.
- Conduct routine compliance reviews and audits, identify documentation or billing risks, communicate findings, and support timely corrective action.
- Coordinate with leadership, program staff, and the third-party biller to address compliance and billing questions, as well as promote accurate, sustainable billing practices.
- Stay current on relevant Medicaid regulations, documentation standards, billing requirements, and reimbursement policies.
PSH Case Manager Documentation Review and Rendering Provider Oversight
- Review PSH case manager notes and related records for clinical appropriateness, completeness, timeliness, medical necessity, and compliance with Medicaid and organizational standards.
- Provide clear, timely feedback and technical assistance to case managers regarding documentation and billable-service requirements.
- Track recurring issues and recommend practical improvements to documentation, workflows, training, and quality assurance processes.
- Provide rendering-provider oversight for designated PSH case managers in accordance with HCPF’s supportive housing billing program under the 1115 waiver
- Review and address clinical or compliance concerns connected to services delivered under the contractor’s rendering-provider credentials.
- Collaborate with program leadership to clarify roles, escalation pathways, and safeguards related to rendering-provider responsibilities.
Additional Support, as Assigned
- Provide clinical consultation to behavioral health team members as needed.
- Direct staff supervision may be included based on organizational need and mutual agreement; the final scope will be determined before or during the contract period.
- Provide clinical consultation for case management team, risk assessment support, crisis guidance, or limited direct clinical services to clients and staff when needed and within the agreed scope.
- Participate in relevant meetings and communicate significant compliance, documentation, clinical, or operational concerns to leadership.
Qualifications, Skills & Abilities:
- Current, unrestricted Colorado license for independent clinical practice as an LCSW or LPC; provisional clinical licenses are not eligible.
- Demonstrated knowledge of Medicaid compliance, documentation, medical-necessity, and billing requirements.
- Experience reviewing clinical or case management documentation and providing actionable feedback.
- Ability and willingness to serve as a rendering provider and fulfill the associated oversight and compliance responsibilities.
- Experience with Permanent Supportive Housing, homelessness services, or community behavioral health is preferred.
- Experience supporting people with serious mental illness, substance use disorders, complex needs, or histories of homelessness is preferred.
- Sound clinical judgment, strong attention to detail, and ability to identify and communicate compliance and client-safety concerns.
- Strong organization, communication, consultation, and problem-solving skills, including the ability to work independently within a time-limited assignment.
- Ability to maintain confidentiality and comply with applicable privacy, ethical, licensing, payer, and organizational requirements.
All Roads is an Equal Employment Opportunity Employer