Job Type
Full-time
Description
The Director of Quality & Compliance reports to the Chief Operating Officer and leads the Quality and Compliance Department. The Director of Quality & Compliance also reports all clinical compliance issues directly to the Chief Executive Officer. This position contributes to the fulfillment of the organization's mission and vision by performing quality & compliance audits and monitoring essential services in compliance with federal and state regulations, federal compliance guidelines and accreditation standards.
This position directs employees in quality and regulatory compliance, maintains the effectiveness of the Corporate Compliance program; serves as the primary compliance resource for Medicaid/Medicare reimbursement information, and maintains compliance with reimbursement and regulatory standards.
Work hours: Full-Time, Monday through Friday, 8:00am-5:00pm.
Salary: $145,000.00 - $158,000.00 annually.
Location: Escondido, CA
Travel: Travel required for oversight of agency regulatory compliance and other organizational activities. Occasional travel for educational purposes.
Requirements
1. Performs organization wide, program and department audits to investigate and monitor compliance with federal and state laws and regulations, Medicare and Medicaid laws and regulations, current coding and billing guidelines and the HIPAA Privacy Standards.
2. Provides professional education on corporate responsibility, ethical principles, and service recovery.
3. Responsible for the overall risk management of the organization focusing on high risk, problem prone areas.
4. Chairs the quality and compliance committees.
5. Works closely with clinical and financial departments to ensure corrective actions are implemented to prevent and/or correct any discrepancies in billing to Medicare, Medi-Cal or commercial payors.
6. Oversees the quality and medical records departments.
7. Establishes and maintains a mechanism to track access to protected health information.
8. Works with the Infection Control Nurse for the overall monitoring & tracking of infection control in patient care delivery.
9. Responsible for the documentation and tracking of the service recovery process and handling of complaints with the assistance of clinical services.
10. Ensures all hospice quality and compliance audits are completed annually and as needed to maintain compliance with the Conditions of Participation and accreditation standards.
11. Performs other duties as assigned.
LEADERSHIP:
1. Serves as an active and contributing senior leader member and effectively collaborates with colleagues.
2. Inspirational and effective management skills to mentor and motivate staff, leverage existing capacity, delegate appropriately, and strengthen performance while maintaining best practices, camaraderie, and shared accountability.
3. Creates a work environment which encourages participation in order to promote retention, productivity, and a quality, customer-oriented staff; and utilizes clearly defined goals, objectives, and methods with which to measure success.
4. Takes action to enforce rules; confronts others about problems when necessary.
5. Empower others by sharing responsibility to encourage a deep sense of commitment and ownership.
6. Demonstrates creativity and innovation. Takes reasonable risks and accepts full accountability for actions taken.
7. Allow subordinates to take reasonable risks and accept accountability for their actions.
8. Develops a spirit of cooperation and teamwork while leading a group of people.
9. Works for solutions that generally benefit all involved parties.
10. Demonstrates self-confidence, positive image and ability to think conceptually in leading and directing others.
11. Recognizes complex connections in situations and is able to identify the key or underlying issues.
12. Demonstrates the ability to make decisions independently that benefit the agency as a whole based on the identification of key or underlying issues.
QUALIFICATIONS:
1. A bachelor's degree in nursing is required. If the bachelor's degree is not in nursing, then one of the candidate's degrees must be in nursing. A master's degree in healthcare administration, public health, or a related field is preferred.
2. Minimum of 5 years of healthcare leadership and/or quality assurance/compliance experience. Experience in healthcare compliance regulations required.
3. Proficiency in quality improvement methodologies such as Lean Six Sigma , or Continuous Quality Improvement (CQI). Experience with data analysis and performance improvement initiatives is crucial. Experience or familiarity with audit construction.
4. Experience working with time sensitive, confidential projects.
5. Working knowledge of compliance activity plans and Corporate Compliance required elements.
6. Demonstrated success in strategic planning and implementation of tactics to achieve goals, along with success in managing the work efforts of others. Ability to align the department's objectives with that of other senior leaders so the agency grows and prospers in a harmonious, team-oriented manner.
7. Professional certification such as Certified Professional in Healthcare Quality (CPHQ), Certified Professional in Healthcare Risk Management (CPHRM), Healthcare Compliance Certification (HCCA) preferred.
8. Innovative problem-solving abilities.
9. Registered Nursing license must be current and unencumbered. Excellent organizational, time management, and communication skills.
10. Working knowledge of MS Office Suite.
11. Current California driver's license and proof of auto insurance required.
We place a high importance on our employees and reward staff in several ways such as:
- Competitive hospice industry compensation
- Benefits package with multiple plan offerings and generous employer contribution
- 401(k) Retirement plan with employer match
- Supportive work culture which encourages work life balance
- Paid Time Off, paid holidays & floating holiday
- Employee development program managed by in-house education department to support individualized orientation and professional growth needs.
- Tuition reimbursement program
- Monthly mileage reimbursement
- Employee Referral Program
Salary Description
$145,000-$158,000 annually
