Quality Improvement and Compliance Manager

Job Title

Quality Improvement and Compliance Manager

Miami Jewish Health is one of the largest providers of healthcare and living options for aging adults in the Southeast. We operate Florida PACE (Program of All-Inclusive Care for the Elderly) Centers, the largest PACE program in Florida, which serves as health plan, healthcare provider, and social center designed for older adults with complex medical needs. We have four adult day health centers that serve participants in Miami-Dade and Broward counties.

The following Job Description will also apply at Broward Pace Program sites.

Our careers are challenging, meaningful and rewarding. Join us now to do purposeful work in supporting our community’s seniors and their families.

The quality manager provides guidance in establishing and monitoring strategy to set and achieve quality goals. That strategy, supported by the development of an annual QI plan, should include specific quality measures and metrics to evaluate progress and guide necessary adjustments. Data collection and analysis are at the heart of quality improvement. Ongoing tracking and analysis of data is imperative to identify performance trends, significant results, and opportunities for performance improvement based on sound methodology.

This position manages the PACE performance improvement activities by adapting and implementing PACE Performance Improvement Plan, policies and procedures that will ensure all PACE sites compliance with CMS, AHCA, and Health Insurance Portability and Accountability Act (HIPAA) regulations.

Responsible for the development, implementation, and oversight of the quality dashboard;
Leads Performance Improvement teams;
Compiles, analyzes and identifies trends to prioritize performance improvement goals and objectives. Investigates incidents, conducts audits, and coordinates preparation and submission of responses / corrective action plans for senior management. Represents Florida PACE Centers at meetings and conferences and provides support to the Florida PACE Centers Associate Vice President. This position reports directly to the Associate Vice President.

• Designs, implements, and maintains Quality Improvement program for FPC.Trains managers and supervisors in essential monitoring methods and measurement techniques specific to quality indicators.
• Monitors indicator reports to track trends and ensure that significant trends are being reported to the Associate Vice President
• Identifies critical control points and preventive measures : establishing critical limits, monitoring procedures, corrective actions, and verification procedures
• Designs reporting schedule, develops agendas, leads discussions, and records meeting minutes
• Develops in collaboration with the Associate Vice President, Medical Directors the formulation of the annual Quality and Compliance Plan
• Represents Florida PACE at meetings and conferences as necessary
• Responsible for the development of policies and procedures for Florida PACE Centers
• Serves as Privacy Office for FPC.
• Oversees Contract Management program for FPC.
• Responsible for managing all internal QI teams and activities and reporting to regulatory agencies.
• Enforces continuous compliance with regulatory and contractual requirements
• Coordinates and leads PI meetings in conjunction with Chairperson
• Acts as credentialing officer, creates profiles, presents to the credentialing committee, and manages the re-credentialing process in a timely manner as needed
• Participates in continuing education programs and related community activities
• Maintains up to date knowledge of current trends, laws, and philosophies in regard to healthcare and management
• Attends department meetings and in-services as needed

• Bachelor’s Degree preferred

• Five years’ experience in the Quality Assurance / PI or risk management

• Certified Professional in Healthcare Quality (CPHQ) preferred

• Computer knowledge;
  Power Point, Excel, Visio, Word, Policy Tech, MS outlook,
• Costumer Service Skills, Bilingual,
• Regulatory and Accredited Agencies Expertise : AHCA, CMS, DOEA, etc.