POSITION SUMMARY: The Quality and Compliance Manager is responsible for supporting the Quality and Compliance department, while managing the day to day activities. A successful QC Manager will help develop and support a culture of quality, has advanced relationship management skills and attention to detail that ensures RMHCS participants are receiving the highest quality of care possible. This QC Manager interacts with all levels of the organization so advanced interpersonal communication skills are vital for the success of this position.
Reviews outcomes data prior to its submission to Medicare/Medicaid or any other entity to ensure accuracy and communicates the findings to the Quality and Compliance team
- Maintains a working knowledge of continuous improvement processes as they relate to regulatory and accreditation agencies to work with senior management on ways to improve the quality of RMHCS services
- Assists with Federal and State survey readiness. Assists with completion, submission and follow up on corrective action plans
- Develops infrastructure designed to monitor and improve the quality and performance of evidence-based healthcare and maximize effectiveness and efficiency of health care practices
- Assists Quality and Compliance Analyst with the analysis, synthesis and representation of data resulting from audits and helps QC team develop a plan to address trends and patterns
- Creates and distributes regular reports assigned by the Officer of Quality and Compliance
- Supports Q&C Department with root cause analysis activities
- Leads Quality projects based on data utilizing the Plan, Do, Study, Act model and Lean Six Sigma
Supports departmental projects, as needed
- Leads and Facilitates the Quality Initiative (QI) Committee along with other members of PACE leadership and ensures that all activities of committee are executed as prescribed in the PACE manual and by internal standards
- Supervises the Administrative Assistant, Quality and Compliance Specialist, and Quality and Compliance Analyst
- Managing day to day departmental operations
- Other duties as assigned
Bachelor’s Degree in healthcare or related field
- Minimum of 1-3 years’ experience in quality management/improvement in the health care industry or comparable education/experience required
- Certification from NAHQ or in Lean, Six Sigma or other similar training required or obtained within 2 years of hire date
- Knowledge of statistical and data analysis required
- Experience in leading process improvement efforts and facilitating committees or other results-oriented meetings
- Strong documentation skills and information management highly desired, including capturing documentation in an Electronic Health Record
- Familiarity with reading and interpreting medical documentation and orders from an attending physician, nurse practitioner or other providers