Director of Quality and Compliance

Description

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.

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.

Our Mission:
To enhance the quality of life for those nearing the end of life's journey and for those who grieve.

Work hours: Full-Time, Monday through Friday, 8:00am-5:00pm.

Salary: $ - $ annually.

Location: Escondido, CA

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

Requirements

1. 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.

2. Provides professional education on corporate responsibility, ethical principles, and service recovery.

3. Responsible for the overall risk management of the organization focusing on high risk, problem prone areas.

4. Chairs the quality and compliance committees.

5. 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.

6. Oversees the quality and medical records departments.

7. Establishes and maintains a mechanism to track access to protected health information.

8. Works with the Infection Control Nurse for the overall monitoring & tracking of infection control in patient care delivery.

9. Responsible for the documentation and tracking of the service recovery process and handling of complaints with the assistance of clinical services.

10. Ensures all hospice quality and compliance audits are completed annually and as needed to maintain compliance with the Conditions of Participation and accreditation standards.

11. Performs other duties as assigned.

LEADERSHIP:

1. Serves as an active and contributing senior leader member and effectively collaborates with colleagues.

2. Inspirational and effective management skills to mentor and motivate staff, leverage existing capacity, delegate appropriately, and strengthen performance while maintaining best practices, camaraderie, and shared accountability.

3. Creates a work environment which encourages participation in order to promote retention, productivity, and a quality, customer-oriented staff; and utilizes clearly defined goals, objectives, and methods with which to measure success.

4. Takes action to enforce rules; confronts others about problems when necessary.

5. Empower others by sharing responsibility to encourage a deep sense of commitment and ownership.

6. Demonstrates…