Director of Compliance, Quality Improvment an

Job Description Description

• The Director Quality Assurance, Compliance and Risk Management, will play an integral role in the day-to-day operations of Milestones Services and its affiliates.
• This individual in this role will lead the quality assurance, compliance, human resources and risk management functions including quality improvement and compliance oversight, quality and compliance related strategy and process improvement.
• The intent of this role is to be trained to transition into the role of Executive Director with the capacity to provide full company oversight.

Reports to Executive Director

• Health Information Manager
• Human Resources Coordinator

• Develops organizational compliance strategies by contributing information, analysis, and recommendations to strategic thinking and direction, establishing functional objectives in line with organizational strategic plans and objectives.
• Establishes compliance operational strategies by evaluating trends; establishing critical measurements; determining production, productivity, quality, and customer-service strategies; designing systems; accumulating resources; resolving problems; implementing change.
• Protects assets by establishing compliance and risk management standards; anticipating emerging compliance trends; designing improvements to internal control structure.
• Avoids legal challenges by understanding current and proposed legislation; enforcing regulations; recommending new procedures and protocols; complying with legal requirements.
• Updates job knowledge by participating in educational opportunities; reading professional publications; maintaining professional networks; participating in professional organizations.
• Enhances compliance and organization reputation by accepting ownership for accomplishing new and different requests and exploring new and innovative opportunities to improve processes and better serve our key stakeholders.
• Identifies areas of organizational vulnerability as it relates to client health, safety and welfare, employee training, developing standard operating procedures, policies and company protocols.
• Maintains files and documents in an organized format as outlined in agency procedures.
• Oversees client and employee file and database maintenance.
• Ensures on-boarding of new employees in accordance with policies, procedures, state regulations and federal regulations.
• Ensures that all forms, monthly summary notes and billing documentation are received in the office by the 5th of the month.
• Documents all incident reports and ensures that incident reports are completed timely and that investigations are completed within regulatory time frames.
• Is well versed in agency policies, procedures and protocols.
• Is extremely well versed in state and federal regulations as they relate to the services provided including but not limited Supports for Community Living Waiver, Michelle P. Waiver, State and Federal Human Resources Laws and Regulations, etc.
• Sends appropriate information and documentation to case management agencies, guardians and other key stakeholders as needed and appropriate.
• Assists with new client onboarding and transition, including but not limited to assistance with gathering appropriate consents, preparing documents, preparing main file, gathering orders and medical information and ensuring new client medical providers are established.
• Maintains client files and record compliance and enters information into appropriate databases.
• Ensures that all medical forms and documentation for all clients are complete, accurate and received in a timely manner.
• Communicates with and provides information to clients, case managers, guardians and other key stakeholders on a consistent basis and following appointments.
• Ensures HRST is updated with new client information in a timely manner as necessary.
• Ensures all forms and documents are received from case managers in a timely manner and in accordance with regulations.
• Appropriately records and reports significant/major incidents or health, safety and welfare concerns and notifies proper authorities of circumstances or situations that present potential threats.
• Ensures overall client health, safety and welfare of clients through quality audits and process and performance improvement initiatives and programs.
• Fluently understands and has the ability to execute state and federal regulations that relate to client servi