Director of Quality Assurance and Compliance

18 hours ago

Trenton, New Jersey, United States Catholic Charities, Diocese of Trenton Full time
About the Organization

Catholic Charities, Diocese of Trenton is a faith-inspired non-profit organization that is mission-driven, family-friendly, and passionate about serving our communities.

We offer a wide range of exciting career opportunities in various areas, including Direct Care, Clinical, Fundraising, Human Resources, IT, Finance, Marketing, and Nursing.

When you join us, you can expect a true focus on work-life balance, a rewarding career, competitive salaries, and comprehensive benefit programs.


Some of our benefits include:

generous paid holidays, vacation, and sick time; Employee Assistance Program, excellent health & pension plans; Public Student Loan Forgiveness program; and a wide array of training and staff development opportunities to earn on-site CEUs.

Catholic Charities is an Affirmative Action / Equal Opportunity Employer, fostering a diverse and inclusive environment for staff as well as for people seeking assistance.

Job Summary

The Director of Quality Assurance and Compliance is responsible for the overall development, implementation, and management of the Agency Quality Assurance and Compliance Program.

This role involves maintaining and adhering to the organization's policies and procedures covering privacy and access to client clinical information, licensing, and accreditation, in accordance with federal and state laws and agency requirements.

Key Responsibilities
  1. Compliance
  • Oversee and monitor the implementation of compliance programs, including privacy and access to client records, and serve as the agency Ombudsperson for client satisfaction, perception of care inquiries.
  • Work with legal counsel and leadership, key departments, and committees to ensure the organization has and maintains appropriate privacy and confidentiality consent, authorization forms, and information notices and materials reflecting current organization and legal practices and requirements.
  • Periodically update policies and procedures to maintain compliance with laws and regulatory authorities.
  • Coordinate and facilitate annual review of agency-wide policies and procedure manuals (AP, HP, and CP - Administrative, HIPAA/HITECH, and clinical) with summary reports for the annual review by the Strategic Planning Committee of the Board and the Board of Trustees.
  • Develop policies and programs that ensure protocols are in place and staff have options to report suspected fraud and other improprieties without fear of retaliation.
  • Complete False Claims paperwork (Section 6032 Federal Deficit Reduction Act) for review and sign-off by the Executive Director for submission to the Office of the State Comptroller, Medicaid Fraud Division on a yearly basis.
  • Investigate matters related to compliance in accordance with legal guidance and agency policy and procedure. Prepare reports and recommendations in accordance with directives from legal leadership.
  • Investigate client complaints with Human Resources and legal as necessary to resolve concerns and improve quality of care.
  • Assist Leadership and designees in coordinating internal compliance reviews.
  • Develop and implement training programs regarding compliance.
  • Manage incident reporting process to ensure proper and timely reporting.
Agency-wide Accreditation
  • Responsible for the agency-wide accreditation by maintaining up-to-date on accreditation standards/systems/processes in order to maintain and exceed accreditation expectations.
  • Provide educational training, both group and individual, to ensure staff knowledge with the accreditation standards. Complete mock surveys as requested.
  • Develop, coordinate, and facilitate all accreditation site survey review documentation - both documentation for the accreditation portal as well as on-site documentation.
  • Develop accreditation site review schedule to facilitate the effective and efficient use of reviewers.
  • Complete the yearly Maintenance of Accreditation report yearly in order to maintain accreditation.
  • Report all critical incidents and records in accreditation portal.
Licensing, Medicare/Medicaid Reviews
  • Responsible for the coordination and facilitation of all licensing reviews.
  • Provide guidance and training to facilities and security staff for compliance and licensure preparation.
  • Provide education and training to departmental staff as it relates to licensing regulation compliance.
  • Initiate on-site reviews of program sites prior to licensing visits to ensure compliance.
  • Escort licensing review team from site to site in order to assist reviewers in understanding our programs/sites.
  • Coordinate and complete the Plan of Correction for Licensing.
  • Facilitate Medicare/Medicaid reviews and coordinate and complete the plan of correction.
Quality Improvement
  • Responsible for the direction of the agency-wide Quality Improvement Program in accordance with agency's mission, accrediting/licensing requirements, and agency's strategic plan.
  • Chairperson of the Agency-wide Quality Improvement Committee as Quality Improvement subcommittees.
  • Provide training on Logic Model/PDSA/CQI as needed.
  • Compile and present quarterly QI/Logic Model/PDSA reports to the Strategic Planning committee of the board for presentation to the Board of Trustees.
  • Serve as secretary to the Consumer Advisory Committee.
  • Coordinate, complete, and upload CCUSA Program Detail Report, Core Services Report, and CLINIC Immigration reports yearly.
Utilization Management
  • Supervise Utilization Review staff as it relates to data collection, report generation, and timely reporting.
  • Supervise and direct periodic audits as needed to identify areas in need of improvement.
Risk Management and Safety
  • Manage Risk Management Program by reviewing all incident reports and flagging and monitoring those that need additional action steps and rapid cycle PDSA.
  • Manage risk management insurance program serving as liaison to the Chancery on insurance matters and renewals.
  • Via incident reporting system, notify and/or send reminder to directors when case reviews are needed.
  • Report all critical incidents to accrediting group, if required.
  • Chairperson of the Agency Safety Committee as well as the Mercer Campus Safety Subcommittee.
  • Develop agenda for the Safety Committee and utilize Risk Management Incident report to develop PDSA and other actions steps needed by Maintenance/Programs.
  • Investigate incidents and respond to any OSHA complaints.
  • Serve as member COVID workgroup to address pandemic-related issues.
Health Information Management and Reporting
  • Manage EHR Clinical system to ensure compliance and reporting functionality.
  • Oversee training resources for clinical modules of EHR.
  • Assist with reporting functionality and training of EHR.
  • Ensure EHR maintains compliance with level of care licensing standards.
  • Conduct system audits to ensure proper functionality of EHR.

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