Quality Assurance & Compliance Officer

Quality Assurance & Compliance Officer

Department: Quality, Compliance & Clinical Operations

Reports To: Executive Leadership / CEO

Works Closely With: Clinical Director, Regional Managers, BCBAs, RCM, Intake, HR, and

Operations

Position Summary

The Quality Assurance & Compliance Officer is responsible for developing, implementing, and

monitoring Know Boundaries quality assurance and compliance systems across all service

locations and states. This position ensures that clinical services, documentation, employee

requirements and operational processes are consistently aligned with applicable laws,

regulations, and company policies.

The QA & Compliance Officer will establish a proactive culture of compliance by identifying risks

before they become problems, monitoring performance through regular audits, developing

corrective action plans, and partnering with clinical and operational leadership to continuously

improve the quality and efficiency of services.

Core Responsibilities

Clinical Documentation & Quality Audits

Develop and maintain a standardized audit program for:

● Assessments and reassessments

● Treatment plans

● Progress reports

● Session notes

● Parent/caregiver training documentation

● Supervision documentation

● BCBA documentation

● RBT documentation

● Treatment integrity

● Discharge documentation

Conduct routine audits to identify:

● Missing documentation

● Late documentation

● Inconsistent documentation

● Billing/documentation discrepancies

● Authorization issues

● Clinical compliance concerns

Provide feedback and corrective action plans when needed.

State & Regulatory Compliance

Maintain a compliance matrix for every state in which Know Boundaries operates.

Monitor requirements related to:

● BCBA licensure

● RBT requirements

● Supervision

● Background checks

● Training

● Medicaid requirements

● Commercial payer requirements

● Clinical documentation

● Record retention

● Employee credentialing

RBT & Employee Compliance

Partner with HR and Clinical Operations to ensure required employee documentation remains

current.

Monitor:

● Background checks

● RBT certification

● BCBA licensure

● Professional licenses

● Required training

● Competency assessments

● Supervision requirements

● Annual/recurring training

● Employee files

Improve internal tracking system as needed

Incident Management

Develop and maintain a standardized process for reporting and investigating:

● Client incidents

● Injuries

● Safety concerns

● Allegations of abuse/neglect

● Medication-related concerns

● Elopement

● Significant behavioral events

● Parent complaints

● Employee complaints

● Privacy/HIPAA concerns

Ensure appropriate documentation, escalation, investigation, and follow-up.

HIPAA & Privacy Compliance

Oversee compliance related to:

● HIPAA

● Protected Health Information

● Electronic records

● Client communications

● Release of information

● Data security

● Privacy policies

● Staff privacy training

Conduct periodic audits of privacy practices.

Internal Audit Program

Establish a recurring audit schedule. Demonstrate strong competence with Insights reports and

Central Reach. Specific reporting to be updated as needed

Monthly

● Documentation audits

● RBT supervision audits

● Credentialing audits

● Incident review

● Billing/documentation review

Quarterly

● Full clinical compliance audit

● Payer compliance review

● State compliance review

● Policy/SOP review

● Corrective action follow-up

Annually

● Enterprise-wide compliance assessment

● Risk assessment

● Policy review

● Compliance training

● Emergency preparedness review

Conduct other tasks and duties as assigned