Director Quality Management/compliance Officer

3 weeks ago

Staten Island, United States Centers Plan for Healthy Living Full time

Director of Quality and Compliance
The Director of Quality and Compliance strives to ensure that all Agency personnel adhere to regulatory requirements, including but not limited to the Federal Conditions of Participation (COPs), New York State Department of Health Regulations outlined in NYCRR 10 section 763, Medicare and Medicaid billing rules and other governmental oversight and that services provided meet the highest quality standards.
This position also performs a variety of other duties including oversight of patient rights and patient confidentiality and privacy standards; patient satisfaction surveying; infection control and risk management; policy and procedure development and maintenance; compliance with licensing, and health monitoring and mandatory facility education requirements; emergency management; and performance improvement.

**Responsibilities**:

- Development, implementation, and evaluation of the Agency’s Quality Assessment Performance Improvement Program (QAPI).
- Development, implementation, and evaluation of the Agency’s Corporate Compliance Program. Serves as the Agency’s Compliance Officer. Ensure effective staff training and monitoring of problem prone areas of compliance.
- Development, implementation, and evaluation of the Agency’s Emergency Management Program. Ensures effective staff training; ensures drills are performed including completion of after action reports; and ensures completion of the annual Hazard Vulnerability Assessment (HVA).
- Development, review and revision of Agency policies and procedures to ensure alignment with regulatory requirements. Maintains the policy and procedure manual. Provides guidance to all staff on Agency policy.
- Development, implementation, and evaluation of the Agency’s program related to patient privacy and confidentiality to meet all federal Office of Civil Rights Health Insurance Portability Accountability Act (HIPAA) regulations. Serves as the Agency’s Privacy Officer.
- Participates in all external auditing including but not limited to NYS DOH surveys, and Medicare and Medicaid auditing. Develops and ensures implementation of plans of correction and ensures that responses to all auditing are timely. Maintains records of auditing.
- Oversight of complaint resolution. Ensures timely follow-up and documentation. Maintains the Agency’s complaint log per DOH requirements.
- Oversight of services provided through outside vendors. Reviews all vendor documents to ensure compliance with regulatory requirements prior to contracting. Ensures all contracts meet regulatory requirements and Agency policy.
- Monitors Agency quality measures related to OASIS and claims-based outcomes and HHCAHPS. Maintains accounts on iqies and HHCAHPS sites to obtain quality data.
- Oversight of Medicare Expedited appeals and conventional Medicare appeals process. Maintains records of all appeals. Serves as the Agency’s contact with the Medicare QIO.
- Oversight of risk management, including documentation and maintenance of patient and staff incident reporting. Serves as liaison with Agency attorneys related to legal action.
- Oversight of patient medical record release to ensure compliance with HIPAA regulations according to minimum necessary rules.
- Oversight of quarterly utilization review and other record auditing related to regulatory requirements, performance improvement, plans of correction and other focused reviews.
- Development of training programs related to the COPs/DOH regulatory requirements, QAPI, Corporate Compliance, HIPAA, and Emergency Management. Participates in orientation and annual mandatory inservice development and implementation.
- Serves as the Agency’s coordinator on NYS Health Commerce System. Responds to DOH HERDS reports when required.
- Maintains relationship with the Home Care Association of NYS. Keeps abreast of information from NYS DOH, CMS, NGS, OCR, OIG, OMIG and shares information with Agency leadership.
- Works with the Agency’s VP of Clinical Operations and Staff Development to develop the orientation and educational programs to meet regulatory requirements.
- Works with Human Resources to understand regulatory requirements as they pertain to personnel.
- Supervises the Quality Management Clinical Analyst and the Quality Management Assistant.
- In collaboration with each department, provides the appropriate guidance to ensure adherence to regulatory requirements.
- Other job duties as assigned.

**Committee Responsibilities**:

- Quarterly Professional Advisory Committee
- Quarterly Corporate Compliance Committee
- Annual and ad hoc Emergency Management Team

Job Qualifications Required
- New York RN licensure
- Minimum two years home care experience in a Certified Home Health Agency
- Minimum one year experience with quality management preferred.
- Knowledge of applicable federal and state laws and regulations
- Ability to write reports, policy, and other correspondence.
- Ability to work with and throu

  • Quality Management Assistant

    3 weeks ago

    Staten Island, United States Centers Plan for Healthy Living Full time

    Quality Management Assistant 75 Vanderbilt Ave, Staten Island, NY 10304, USA Req #11963 Monday, May 13, 2024 Quality Management Assistant Duties and Responsibilities + Provides general clerical assistance to the QM Director/Compliance Officer and the QM Clinical Analyst such as faxing, copying, scanning and file maintenance. + Medical Record Requests:...

  • Quality Management Assistant

    12 hours ago

    Staten Island, United States Centers Plan for Healthy Living Full time

    Quality Management Assistant 75 Vanderbilt Ave, Staten Island, NY 10304, USA Req #11963 Monday, May 13, 2024 Quality Management Assistant Duties and Responsibilities + Provides general clerical assistance to the QM Director/Compliance Officer and the QM Clinical Analyst such as faxing, copying, scanning and file maintenance. + Medical Record Requests:...

  • Quality Management Assistant

    1 day ago

    Staten Island, United States Revival Home Health Care Full time

    **Duties and Responsibilities** - Provides general clerical assistance to the QM Director/Compliance Officer and the QM Clinical Analyst such as faxing, copying, scanning and file maintenance. - Medical Record Requests: receives and logs requests, obtains necessary authorizations for release of PHI, prints record for QM clinical review. Works collaboratively...

  • Clinical Quality Management Assistant

    7 days ago

    Staten Island, United States Centers Choice Home Care Full time

    Title: Quality Management Assistant Responsible to: Director Quality Management **Duties**: 1. Provides general clerical assistance to the QM Director/Compliance Officer and the QM Clinical Analyst such as faxing, copying, scanning and file maintenance. 2. Medical Record Requests: receives and logs requests, obtains necessary authorizations for release of...

  • Office/hr Manager

    1 week ago

    Staten Island, United States City Access New York, Inc. Full time

    **Job Title: Office/HR Manager** **Reports To**:Executive Director, Director of Program Services **General Summary**: **Office Manager**:Is responsible for overseeing the daily operations of CANY office and its various departments. The duties include communicating with department heads, relaying important information or policy changes from upper management...

  • Quality Management Clinical Analyst

    2 weeks ago

    Staten Island, United States Centers Plan for Healthy Living Full time

    Quality Management Clinical Analyst 75 Vanderbilt Ave, Staten Island, NY 10304, USA Req #11964 Monday, May 13, 2024 Quality Management Clinical Analyst Duties and Responsibilities + Incident reporting: logging, investigation, ensures written report on file, assists clinical managers with written reports, collates information on a quarterly basis. Provides...

  • Quality Management Clinical Analyst

    2 weeks ago

    Staten Island, United States Centers Plan for Healthy Living Full time

    Quality Management Clinical Analyst 75 Vanderbilt Ave, Staten Island, NY 10304, USA Req #11964 Monday, May 13, 2024 Quality Management Clinical Analyst Duties and Responsibilities + Incident reporting: logging, investigation, ensures written report on file, assists clinical managers with written reports, collates information on a quarterly...

  • Quality Management Clinical Analyst

    1 day ago

    Staten Island, United States Centers Plan for Healthy Living Full time

    Quality Management Clinical Analyst 75 Vanderbilt Ave, Staten Island, NY 10304, USA Req #11964 Monday, May 13, 2024 Quality Management Clinical Analyst Duties and Responsibilities + Incident reporting: logging, investigation, ensures written report on file, assists clinical managers with written reports, collates information on a quarterly...

  • Quality Management Clinical Assistant

    2 weeks ago

    Staten Island, United States Revival Home Health Care Full time

    **Duties and Responsibilities** - Incident reporting: logging, investigation, ensures written report on file, assists clinical managers with written reports, collates information on a quarterly basis. Provides education to clinical staff regarding risk management and incident reporting. - Medicare expedited appeals. Review case, writes detailed notice,...

  • Quality Management Clinical Analyst

    1 day ago

    Staten Island, United States Revival Home Health Care Full time

    **Duties and Responsibilities** - Incident reporting: logging, investigation, ensures written report on file, assists clinical managers with written reports, collates information on a quarterly basis. Provides education to clinical staff regarding risk management and incident reporting. - Medicare expedited appeals. Review case, writes detailed notice,...

  • HR Compliance Manager

    4 weeks ago

    Staten Island, United States Metro One LPSG Security Company Full time

    **HR Compliance Manager - Staten Island, NY** **About Us**: Metro One LPSG is the U.S. leader in providing dedicated security and loss prevention services to national clients. We are a rapidly growing organization transforming the contract security industry and we need talented, committed and determined individuals to help us carry out our mission. Our...

  • Medical Quality Assurance Specialist

    7 days ago

    Staten Island, United States Centers Choice Home Care Full time

    Title: Quality Management Clinical Analyst Responsible to: Director Quality Management 1. Incident reporting: logging, investigation, ensures written report on file, assists clinical managers with written reports, collates information on a quarterly basis. Provides education to clinical staff regarding risk management and incident reporting. 2. Medicare...

  • Compliance Program Manager

    4 days ago

    Staten Island, United States Northwell Health Full time

    Job Description Manages, plans, organizes, supports, and evaluates daily administrative operations for one or more defined compliance programs such as, but not limited to Health Insurance Portability and Accountability Act (HIPAA), coding and billing, Conflicts of Interests (COI) or other compliance program(s). Plans and implements research coding and...

  • Compliance Program Manager

    2 weeks ago

    Staten Island, United States Northwell Health Full time

    Manages, plans, organizes, supports, and evaluates daily administrative operations for one or more defined compliance programs such as, but not limited to Health Insurance Portability and Accountability Act (HIPAA), coding and billing, Conflicts of Interests (COI) or other compliance program(s). Plans and implements research coding and billing and financial...

  • Compliance Program Manager

    2 days ago

    Staten Island, United States Northwell Health Full time

    Manages, plans, organizes, supports, and evaluates daily administrative operations for one or more defined compliance programs such as, but not limited to Health Insurance Portability and Accountability Act (HIPAA), coding and billing, Conflicts of Interests (COI) or other compliance program(s). Plans and implements research coding and billing and financial...

  • Director of Clinical Operations

    1 month ago

    Staten Island, United States EVOLUTION RESEARCH GROUP Full time

    Job DetailsJob LocationLOC022 RBA Richmond Behavioral Associates - Staten Island, NYDirector of Clinical OperationsTitle: Director Clinical Operations Location: Staten Island, NYAbout us:ERG is a leading U.S. based, privately held, independent clinical research site company, and provider of clinical development services with expertise in early and late-stage...

  • Director of Clinical Operations

    17 hours ago

    Staten Island, United States EVOLUTION RESEARCH GROUP Full time

    Job DetailsJob LocationLOC022 RBA Richmond Behavioral Associates - Staten Island, NYDirector of Clinical OperationsTitle: Director Clinical Operations Location: Staten Island, NYAbout us:ERG is a leading U.S. based, privately held, independent clinical research site company, and provider of clinical development services with expertise in early and late-stage...

  • Assistant Director

    7 days ago

    Staten Island, United States Camelot of Staten Island, Inc. Full time

    ***: The Assistant Director will provide direct and continuous supervision of staff under the direction of the Program Director & Clinical and Programs Director, and be responsible for residents. **DUTIES & RESPONSIBILITIES**: - Assist in the operation and discussion of issues that have direct impact at the residential facility. - Supervise personnel and...

  • Director of Nursing

    1 week ago

    Staten Island, United States Centers Plan for Healthy Living Full time

    Director of Nursing 75 Vanderbilt Ave, Staten Island, NY 10304, USA ? Brooklyn, NY, USA Req #11742 Monday, April 29, 2024JOB SUMMARY:Revival Home Health Care, is looking for a Director of Nursing responsible for directing client nursing services provided by the organization and works in collaboration cross functionally with teams throughout the...

  • Director of Nursing

    2 weeks ago

    Staten Island, United States Centers Plan for Healthy Living Full time

    Director of Nursing 75 Vanderbilt Ave, Staten Island, NY 10304, USA ● Brooklyn, NY, USA Req #11742 Monday, April 29, 2024 JOB SUMMARY: Revival Home Health Care, is looking for a Director of Nursing responsible for directing client nursing services provided by the organization and works in collaboration cross functionally with teams throughout the...