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Director of Compliance & Quality Assurance with Remote Option

Company: Southwest CARE Center
Location: Santa Fe
Posted on: September 12, 2020

Job Description:

Director of Compliance & Quality Assurance with Remote Option Administration

Do you believe everyone is entitled to quality healthcare? Do you desire to serve the underserved in our community?

Southwest Care Center (SCC) is a non-profit healthcare organization who has been providing exceptional healthcare to people within our community for over 25 years. We provide services, including medical, behavioral healthcare, and community outreach, with health centers located in Santa Fe, Albuquerque, Farmington, and Roswell, NM. Southwest Care Center is an FQHC-LAL.

SCC has an opportunity for a Director of Compliance & Quality Assurance to join our team. The position is located in Santa Fe, NM with remote option available. Great quality of life/work opportunity with Monday through Friday schedule.

Must have a strong desire to make a difference in the community. Must embrace a team-oriented approach and be comfortable working with and leading a team of clinical and administrative professionals.

Southwest Care Center offers a full benefits package including medical, dental, vision, life, long term and short-term disability and a 401k retirement fund. Essential Duties: COMPLIANCE: Works collaboratively with functional area directors and executives to develop a compliance plan aimed at prevention, detection, education, and resolution of variances. Evaluates plans, policies and procedures as needed for gaps as they relate to emerging regulations or evolving company needs.

Develops an annual workplan that is reflective of identified and prioritized risks of non-compliance.  This plan is submitted to the CEO for approval by the Governing Board Compliance Committee. Provides quarterly updates and reporting dashboards as requested.

Develops and conducts compliance training (no less than annually).

Maintains a compliance hotline in accordance with SCC’s Code of Conduct Policy and leads investigations into reported matter as appropriate. Documents all reported concerns, and includes disposition of concerns in quarterly reports.

Provides expert advice on the development, communication and implementation of key objectives to achieve PCMH certification.

Working collaboratively with clinical stakeholders and the Quality personnel to develop and maintain a quality program including scorecards, metrics and other plans to meet and exceed quality objectives.

Collaboratively participates in initiatives to develop clinical best practices and drives accountability for consistent execution across the organization.

Participates in community and industry activities in an effort to enhance community recognition of SCC and the medical group, and to obtain cooperation and support of the community on issues that impact SCC and the health of the population we serve. Positively represents SCC and the medical group in the community.

Participates in staff meetings and attends other meetings and seminars as requested.

QUALITY ASSURANCE: Organizationally responsible to the overall accountability and responsibility for planning, designing, integrating, implementing, modifying, managing and evaluating the performance improvement program, which is intended to review services to measure and improve the quality of patient care and the appropriateness, effectiveness, and timeliness of services provided.

Incumbent must have the ability to analyze health care data obtained from a variety of sources, including patient care, clinical trials, financial, and demographic data, from conceptualization through presentation of the data; including but not limited to merging data sets, analyzing data and producing meaningful performance improvement reports.

Provides leadership in improving patient care, maintaining standards of care, and directing and teaching personnel in a variety of settings by developing and facilitating the implementation of programs in the health care system which impact patient care at each site.

Responsible for coordinating all continued performance improvement and compliance activities for associated external and accreditation reviews. The incumbent assures year-to-year compliance with standards of outside agencies and regulatory authorities.

Researches information by identifying, locating and extracting relevant data and information from varied sources in order to obtain sufficient, valid and reliable data for analysis and decision-making purposes.

Analyzes information using qualitative and/or quantitative analytical methods in order to understand and draw fact-based conclusions, often from large amounts of information; identifies issues and problems requiring additional research and study and takes appropriate action to ensure sound study results.

Develops, designs and implements clinical quality improvement performance dashboards for SCC clinics to improve patient care while focusing on clinical outcomes and population health. Develops and maintains a clinical data base.

Interacts with a variety of individuals when participating in meetings, making presentations, providing advice and/or recommendations in order to communicate information, share ideas, present recommended solutions, gain agreement and coordinate activities.

investigates any possible adverse events, as defined by Southwest Care Center, state and/or regulatory agencies.

Participates in the planning, coordination and presentation of specific training and educational programs as appropriate to quality improvement needs of SCC.

Participates in conferences, workshops, symposiums and lectures related to quality management.

Develops policies and procedures to support the quality improvement programs.

Develops, implements and oversees (1) satisfaction surveys, (2) quality improvement plans and goals, (3) quality improvement projects. Provides results and recommendations to Leadership Team.

Participates in clinical and programmatic evaluation activities.

Participates in third party reporting requirements related to quality improvement and data.

Conducts an annual evaluation of the quality improvement program and provides results and recommendations to the Leadership Team.

Performs other duties as assigned. Additional duties may include direct support and reporting to other regulatory agencies, as well as other compliance requirements, all to be performed in a timely and accurate manner.

Minimum Qualifications: Experience: Minimum two years compliance and quality experience in a healthcare setting. A minimum of 7 years’ healthcare leadership and/or medical group administration experience. Leadership experience in a Patient Centered Medical Home and or Federally Qualified Health Center required.

Education: Bachelor’s degree in business, health administration, public health, nursing, social work or related field.

Mandatory Knowledge, Skills, Abilities and Other Qualifications: Knowledge of HIPAA guidelines, Medicare/Medicaid regulations and other federal, state and programmatic regulations typically applicable to grant funded, community healthcare organizations.

Budgeting, planning and analysis.

Proven ability to motivate and lead effective cross-functional teams to achieve desired outcomes.

Project Management experience implementing large-scale strategic initiatives which align with business goals across multiple departments/sites with demonstrated success.

Excellent written and verbal communication skills and the ability to handle sensitive and confidential situations and documentation.

Solid analytical, critical thinking and problem-solving skills. Demonstrated effectiveness in identifying operational issues and recommending and implementing solutions to resolve and effectively communicating both in verbal and written formats.

Solid analytical, critical thinking and problem-solving skills.

Ability to maintain and build trust; protect and preserve confidential information along with high attention to detail.

Ability to prioritize effectively and meet strict deadlines while managing multiple, competing tasks in a fast-paced organization.

Strong team player able to form functional relationships with peers and superiors.

Ability to perform other duties as assigned.

Knowledge of Microsoft Office Suite; (Word, Excel, Outlook); internet browser/search engine; and electronic database employee records systems.

Basic operation of a workstation (turn off/on, knowledge of basic functions and components).

Use/storage/maintenance of multiple usernames and passwords.

Use of Windows Explorer (electronic file-handling).

Regular and predictable punctuality and attendance are a requirement of this position.

Performs other duties as required and assigned.

Preferred Qualifications: MSN, MBA, MHA, MSW or similar advanced education.

Experience with AAAHC and/or NCQA accreditation.

Experience in a setting with fully integrated behavioral health and enabling/outreach programs.

To Thrive at Southwest Care Center You Must: Be committed to SCC's mission, vision, and values and demonstrate them to patients, colleagues, and the public in everyday performance and interactions.

Uphold all principles of confidentiality and patient care to the fullest extent.

Adhere to all professional and ethical behavior standards of the healthcare industry.

Interact in an honest, trustworthy and respectful manner with patients, employees, visitors and vendors.

Participate in departmental staff meetings, quality management activities and educational programs.

Comply with Southwest CARE Center policies and procedures.

Maintain a current insurable driver’s license.

Southwest Care Center is an equal opportunity employer. We offer equal employment opportunities to employees and applicants without regard to race, color, religion, sex, age, national origin, disability status, protected veteran status, sexual orientation, gender identity, or any other characteristic protected by federal or state law. Job Details: Location: NM Santa Fe - San Mateo Worker Type: EmployeeRegular Scheduled Weekly Hours: 40

Keywords: Southwest CARE Center, Santa Fe , Director of Compliance & Quality Assurance with Remote Option, Other , Santa Fe, New Mexico

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