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Quality and Compliance Manager
2 months ago
Cenikor Foundation is seeking a highly skilled Quality and Compliance Manager to join our team. As a key member of our organization, you will be responsible for ensuring the highest standards of quality and compliance in our substance abuse treatment programs.
Key Responsibilities- Maintain and track clinical compliance records, ensuring all documentation is accurate and submitted in a timely manner.
- Ensure Milliman standards are met for clinical documentation.
- Collaborate with leadership, Quality Improvement, Training, and Human Resources to identify root cause needs and develop solutions for improved clinical and contract performance.
- Conduct monthly Quality Improvement and regular compliance audits and risk assessments to identify gaps in clinical quality and address any compliance gaps.
You will also be responsible for:
- Conducting New Hire Audits for new clinicians at 30, 60, and 90 days.
- Developing and maintaining clinical standards in conjunction with Quality Improvement, Clinical Managers, and Utilization Review departments, ensuring consistent documentation.
- Training clinicians on appropriate documentation areas to increase clinical quality and timeframes.
- Monitoring and evaluating training program effectiveness, success, and ROI at regular intervals and reporting to the leadership council.
- Coordinating with regulatory agencies and managing communication regarding compliance issues or inspections.
- Monitoring and analyzing quality metrics and trends to drive continuous improvement initiatives.
- Developing and delivering training programs on compliance and quality management topics to employees at all levels.
- Ensuring staff are aware of compliance and quality requirements and understand their roles in maintaining these standards.
- Acting as the primary point of contact for compliance and quality-related inquiries from internal and external stakeholders.
- Collaborating with cross-functional teams to address compliance and quality issues and implement solutions.
- Maintaining a keen understanding of clinical trends, developments, and best practices.
- Conducting spot audits for compliance in Electronic Health Record systems and identifying training opportunities and gaps based on audit results and data analysis.
You will also be responsible for ensuring the completion of the Big 5 performance management tool by the required deadline and using SMART goals to support annual performance compensation review.
Requirements- Bachelor's degree required; Master's degree preferred.
- Two years of supervisory experience.
- Two years of quality or compliance experience.
- Sitting in a normal position for extended periods of time.
- Reaching by extending hand(s) or arm(s) in any direction.
- Finger dexterity required to manipulate objects with fingers rather than with whole hand(s) or arm(s), for example, using a keyboard.
- Communication skills using the written and spoken word.
- Ability to see within normal parameters.
- Ability to hear within normal range.
- Possible exposure to communicable diseases.
- Ability to drive.
- Ability to travel to facilities by various transportation means up to 20% of the time.
- Clinical licensure required (LCDC minimum).
- Valid Driver's License required.
Cenikor Foundation is a dynamic and growing organization that values its employees and provides a positive working environment. We offer a competitive salary and benefits package, as well as opportunities for professional growth and development.