Director of Quality

4 weeks ago

Escondido, United States The Elizabeth Hospice Full time

Overview:
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 and regulatory issues.

The Elizabeth Hospice is San Diego’s oldest non-profit hospice of 45 years. We are growing and looking for talented individuals to join our high performing team and support our mission. We serve all of San Diego county and south Riverside county with multiple hospice office locations.
- Our Mission: To enhance the quality of life for those nearing the end of life’s journey and for those who grieve._

Work Schedule: Monday through Friday, 8:00 a.m.5:00 p.m.

**Salary**: $125,000-$160,000 Subject to experience and qualifications.

Work Location: Escondido, CA

Travel: Travel required for oversight of agency regulatory compliance and other organizational activities.Occasional travel for educational purposes.

**Responsibilities**:

- 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.
- Provides professional education on corporate responsibility, ethical principles, and service recovery.
- Responsible for the overall risk management of the organization focusing on high risk, problem prone areas.
- Chairs the quality and compliance committees.
- 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.
- Oversees the quality and medical records departments.
- Establishes and maintains a mechanism to track access to protected health information.
- Works with the Infection Control Nurse for the overall monitoring & tracking of infection control in patient care delivery.
- Responsible for the documentation and tracking of the service recovery process and handling of complaints with the assistance of clinical services.
- Ensures all hospice quality and compliance audits are completed annually and as needed to maintain compliance with the Conditions of Participation and accreditation standards.
- Performs other duties as assigned.

Qualifications:

- A bachelor's degree in nursing, healthcare administration, public health, or a related field is often required. A master's degree in healthcare administration, public health, or a related field is preferred.
- Minimum of 5 years of healthcare leadership and/or quality assurance/compliance experience. Experience in healthcare compliance regulations required.
- 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.
- Experience working with time sensitive, confidential projects.
- Working knowledge of compliance activity plans and Corporate Compliance required
- Demonstrated success in strategic planning and implementation of tactics to achieve goals, along with the 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.
- Professional certification such as Certified Professional in Healthcare Quality (CPHQ), Certified Professional in Healthcare Risk Management (CPHRM), Healthcare Compliance Certification (HCCA) preferred.
- Innovative problem-solving abilities.

**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
- Substantial 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

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