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Manager, Quality and Risk Compliance

2 months ago

Orlando Florida, United States Orlando Health Full time

Position Overview:


Oversees the operations of Ambulatory Surgery Centers (ASC) and ensures adherence to all relevant regulations and guidelines governing ASC activities.

This includes compliance with entities such as the Agency for Healthcare Administration (AHCA), State Department of Health, and federal regulations. Assists in managing regulatory updates by ensuring that policies and procedures are consistently revised.

Guarantees that ASC programs and services are executed to the highest standards, ensuring optimal patient care.

Develops and coordinates comprehensive systems for risk identification, investigation, and mitigation; maintains a network of informational resources and specialists; conducts risk assessments and evaluates patient care environments.


Key Responsibilities:

  • Collaborates with the Director to manage Facility Licensing, Accreditation, and Operational Standards for all surgical centers.
  • Establishes and maintains a process checklist to ensure ASC policies are current and upheld to the highest standards.
  • Monitors regulatory changes as they arise and recommends necessary adjustments.
  • Conducts project audits to ensure quality assurance across all ASC domains, including financial, medical records, peer reviews, personnel, and credentialing audits.
  • Facilitates root cause analysis investigations and reports on adverse and sentinel events to relevant parties.
  • Provides proactive evaluations of patient safety and medical error processes.
  • Acts as a liaison among all ASC management to enhance communication and consistency while accommodating the unique needs of different facilities.
  • Generates quarterly statistical reports for the Quality/Risk Management Committee and Board of Directors, leads Quality Management (QM) presentations, and documents minutes for QM and Board meetings.
  • Reviews and prepares an inventory of current licenses.
  • Prepares a tracking list of licenses required for acquisitions or new developments, based on facility type and regulatory requirements.
  • Creates and submits licensure applications as mandated by state and federal regulations.
  • Utilizes the PECOS system for appropriate enrollment transactions.
  • Ensures bi-annual renewal of facility licensure with AHCA.
  • Confirms that all center licenses and business tax receipts are up to date (including DEA, Pharmacy, Consultant Pharmacist, Radiation Machines, and Biomedical Waste Permits).
  • Submits applications for regulatory agency re-accreditation and implements accreditation guidelines.
  • Assists facilities in preparing for regulatory agency surveys.
  • Maintains an ongoing process for reviewing and revising ASC policies and procedures to ensure regulatory compliance and alignment with facility protocols; updates policies as necessary and secures all required approvals.
  • Coordinates Benchmarking and Quality Improvement Studies, recommends projects/quality measures that require in-depth analysis, and oversees clinical QI study data collection activities. Documents all activities in AAAHC approved format and reports findings to QM and BOD.
  • Supports the Risk Manager at each Center with the resolution and procurement of medical records for adverse incident reports and Ad Hoc Peer Review.

Qualifications:
Experience

  • Minimum of 3 years of experience in Operating Room/Ambulatory Surgery Center settings.
  • Extensive understanding of healthcare compliance, regulatory requirements, and CMS regulations.
  • Familiarity with AHCA licensure requirements and accreditation standards.
  • Strong leadership capabilities.
  • Excellent interpersonal and communication skills.
  • Strong customer service orientation.
  • Proficient computer skills.