North Country HealthCare
  • Flagstaff, AZ, USA
  • $70,000.00 TO $110,000.00 per year depending on qualifications.
  • Salary
  • Full Time

Full benefits.


GENERAL DESCRIPTION OF POSITION

The Compliance and Quality Manager (CQM) will report to the CEO, but when necessary will have direct access to the Board of Directors to report and make recommendations about regulatory compliance issues. From a compliance perspective, this position coordinates planning, implementation, and maintenance of the corporate compliance program. The position also oversees activities related to the implementation and adherence to NCHC's policies and procedures covering privacy and access to health information in compliance with federal and state law and oversees NCHC's Risk Management program to reduce errors in healthcare processes, improve health outcomes, and increase patient safety. From a quality perspective, the CQM works closely with the Chief Medical Officer and acts as a project manager for innovative quality improvement projects within the organization; planning, executing and finalizing projects according to organizational goals, within deadlines and budget. This includes acquiring resources and coordinating the efforts of team members and third-party contractors or consultants in order to deliver projects according to plan. The CQM is also responsible for overseeing the PCMH recognition process at all locations. This includes providing direct supervision of the Care Manager Supervisor and Care Managers, including program oversight. The CQM is responsible for the care transitions program and the care opportunities program with the various health plans.

ESSENTIAL DUTIES AND RESPONSIBILITIES

  1. Reviews and revises the corporate compliance plan as needed.
  2. Studies existing and new legislation, anticipated future legislation, and informs leadership of pending regulatory changes.
  3. Participates in trainings related to compliance activities.
  4. Oversees, develops and provides compliance training and serves as a resource for all staff.
  5. Collaborates with other departments and leadership to perform internal compliance audits or monitoring activities, and investigates and resolves compliance issues.
  6. Consults with attorneys and other resources as needed to resolve difficult legal compliance issues.
  7. Ensures proper reporting of violations or potential violations to duly authorized enforcement agencies as appropriate and/or required.
  8. Coordinates policy and procedure development and implementation for all departments.
  9. Facilitates and assists with FTCA compliance, including completion of the FTCA redeeming application annually.
  10. Coordinates and assists with the State licensure process.
  11. Plans and contributes to development of risk management systems. Monitors, investigates, and reports patient adverse events, malpractice claims, incident reports and any indicators of potential harm identified.
  12. Gathers risk related data from internal and external sources, identifies and analyzes areas of potential risk, and informs leadership on how to manage and control key risks.
  13. Reviews current literature or other resources for risk management and control.
  14. Assists in development of tracking and reporting processes for medical record documentation, tracking of referrals and assessment of clinical outcomes.
  15. Responsible for management and processing of all claims activities. Serves as the point person for communication with attorneys and the Federal Office of General Counsel.
  16. Responsible for management and processing of all subpoenas. Educates staff and serves as a resource when cases for custody, disability, and so forth arise.
  17. Functions as the chair of the Compliance, Risk, and Privacy Committee.
  18. Participates in the Continuous Quality Improvement Committee and the Governing Board.
  19. Direct and manage project development. This includes: Developing project plans, timelines and deliverables; communicating project expectations to team members; acting as a liaison to project stakeholders; determining and assessing the need for additional employees; managing expectations with team members and stakeholders; and identifying potential funding opportunities.
  20. Care management and PCMH program oversight at all access points.
  21. Act as the administrator for the incident reporting portal.
  22. Provide supervision to the Care Manager Supervisor, Care Managers, and care transition team members.
  23. Regular and predictable attendance.
  24. Continuous learning in both personal and professional development.
  25. Consistent review, comprehension and reply of company email and related correspondence.

REQUIRED CERTIFICATES, LICENSES, REGISTRATIONS

  1. Bachelor's Degree from a four-year college or university in nursing, health care administration, or closely related field.
  2. CHCC (Certifed Health Care Compliance), CCEP (Certified Compliance and Ethics Professional), or equivalent required.

REQUIRED EXPERIENCE

  1. Five years related experience and/or training, and three years related management experience, or equivalent combination of education and experience.

PREFERRED CERTIFICATES, LICENSES, REGISTRATIONS

  1. Community Health Center experience.
  2. Master's Degree in nursing, health care administration or closely related field.
  3. Senior management experience.

SALARY

$70,000.00 TO $110,000.00 per year depending on qualifications.

North Country HealthCare
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