HopeHealth is seeking an experienced Quality and Compliance Manager for its affiliate Hope Hospice & Palliative Care Rhode Island. This position will be based in Providence, RI.
Under the supervision of the Vice President of Quality & Performance Improvement, this position has organization-wide responsibility for developing and updating tools and processes to support strong clinical quality and compliant practice. This position leads performance improvement activities throughout the organization in response to audit and survey findings. Position insures that audit processes, quality reporting metrics and external audit responses meet federal and state regulations and external accreditation requirements. Position manages direct reports within the department to maximize productivity, quality and response to internal and external customers' requests. Position serves as a resource to the leadership team in pursuit of excellent and compliant organizational performance.
Duties / Responsibilities
Assess for appropriate levels and feedback loops of the auditing processes which support regulatory, accreditation and clinical risk management structures in the organization.
Develop and update tools, processes and practices to support compliance in clinical, financial and administrative areas.
Creates audits and reporting tools to support Quality initiatives throughout the organization in collaboration with the VP Quality and/or leadership teams.
Assumes lead role in the coordination of survey process preparation and readiness; including CHAP, RI State and federal surveys.
Coordinates written response to external payer medical record audits (i.e. ADR, Part D, CERT or Part B audits etc.) and tracks and reports outcomes of responses.
Maintains all records and reports in formats accessible for use by external auditors and accreditation organizations.
Independently responsible for the ongoing function and output of the Policy and Procedure Committee; insuring organizational policies which meet all federal, state and organizational requirements. Manages contract feedback auditing and reporting process.
Collects and analyzes quality and audit data for Quality Department including National Hospice Workgroup benchmarking data, CMS reportables, (i.e.: HIS and CAHPS) and targeted internal metrics identified by the Board of Directors or senior leadership team.
Coordinates and responds to Level 2 Incidents and Complaints and maintains reporting process.
Assists and supports VP Quality in maximizing employee engagement in the Quality department and for promoting a customer focus in all departmental interactions.
Responsible for introductory reviews, annual reviews and performance management processes for direct reports.
Education / Experience
BSN/MSW; Master's Degree preferred.
Five (5) years healthcare experience with in-depth clinical knowledge to include a minimum of two years nursing experience in a Home Care/Hospice setting.
At least three years of hospice experience
Experience with CHAP accreditation survey preferred.
Experience in quality improvement in a health care setting preferred
Highly effective communication skills
Technological expertise including Word, Excel and data mining from various sources
The HopeHealth benefits package features competitive heath care benefits, company provided life insurance, mileage reimbursement, generous paid time off and holidays, a robust orientation program, and a company matched retirement program.
HopeHealth's headquarters are based in Providence, Rhode Island. Its affiliate members are Hope Hospice & Palliative Care Rhode Island, Hope Palliative Care Center, HopeHealth Massachusetts and Visiting Nurse of HopeHealth.
HopeHealth is an Equal Opportunity Employer.