Position: Director of Quality/Compliance Officer - Home Health & Hospice
Reports to: CEO/Administrator
Location: Hybrid position
Responsibilities:- Lead agency-wide compliance and quality: oversee QA department, Quality Assurance & Performance Improvement (QAPI) initiatives, and Education/Training team.
- Ensure adherence to all Medicare home health/hospice regulations (OASIS/PDGM, hospice benefit, QRP) and accreditation standards (e.g., ACHC, CHAP if relevant).
- Manage all audits and surveys: plan for and respond to RAC/UPIC requests, state surveys, and internal reviews.
- Oversee OASIS and HOPE/HIS data quality: review trends, error rates, and implement corrective action plans.
- Develop, update, and enforce policies and procedures (Medicare CoPs, documentation requirements, compliance plans).
- Conduct regular compliance training for clinicians (OASIS training, documentation accuracy, HIPAA).
- Oversee Staff Orientation and education program: ensure staff continuing education, certification renewals, competency evaluations, and ongoing professional development in compliance with organizational and regulatory requirements.
- Monitor Medicare denials and appeals: work with billing and clinical staff to correct systemic issues.
- Collaborate with clinical leadership and the governing board on compliance strategy, reporting key metrics.
Qualifications (Must):- Certifications: OASIS (COS-C or HCS-O) and coding (HCS-D or HCS-H or CPC/CCS).
- Experience: 5+ years in home health/hospice clinical or coding roles, with 2+ years in QA/compliance leadership.
- Medicare Knowledge: Deep understanding of PDGM, HH PPS, Hospice Medicare rules, and documentation standards.
- Education: Bachelor's in nursing, preferred.
- Licensed RN.
- Management: Experience supervising teams (QA, education, coders). Strong policy development and analytical skills.
Preferred (Nice to Have):- Certifications: OASIS (COS-C or HCS-O) and coding (HCS-D or HCS-H or CPC/CCS).
- Compliance/Quality certifications (e.g. CHC, CHPC, CPHQ).
- Experience with HOPE implementation or Hospice Quality measures.
- Prior success leading multi-disciplinary committees.
