Position Information

Quality, Risk Management and Compliance Officer
JOB DESCRIPTION:
 
The Quality, Risk Management, and Compliance Officer (QRCO) will be required to take direction and work intuitively to support the completion of the quality and risk management department’s goals and objectives.  The QRCO is responsible for programs, policies that ensure departments follow all applicable State Federal and Accrediting requirements, as applicable. The QRCO will work closely with senior and executive level staff to facilitate the achievement of the highest quality of care, utilization of services, patient experience and patient safety for client’s receiving services at the health center. The QRCO will work independently on projects and must be able to work under pressure at times to handle a wide variety of activities and confidential matters with discretion. Duties, responsibilities, and activities may change at any time with or without notice.
 
JOB RESPONSIBILITIES (includes, but not limited to):
 
  • Oversees a corporate wide quality improvement program inclusive of all staff, develops and maintains a written quality improvement and risk management plan and annual evaluation of the plan’s effectiveness.
  • Develops and maintains a performance measurement work plan and reporting calendar to ensure timely data collection, aggregation, analysis, and reporting of established performance measures related to key operational and clinical processes and outcomes.
  • Oversees the timeliness of staff in carrying out data collection from CAREWare (CW) and eClinicalWorks (eCW), analysis of findings and report writing.
  • Leads improvement teams through the Plan Do Study Act cycle and reports on outcomes.
  • Provide input in report generation to health center staff responsible for system report writing.
  • Manages electronic storage of quality improvement reports to promote ongoing access for key stakeholders.
  • Oversees a compliance program, develops, and maintains a written compliance plan and annual evaluation of the plan’s effectiveness; ensures that all required elements of a compliance program are addressed.
  • Develops and maintains policies and procedures related to the organization’s quality, risk, and corporate compliance program.
  • Develops and maintains the written Code of Conduct and ensures staff and Board members receive the appropriate training/education.
  • Serves as a resource for the Chief Operations Officer for all external and internal compliance audits; ensures that corrective action plans are documented in a timely manner and effectively implemented.[CH1] 
  • Oversees investigations relating to reports of known or suspected violations of the corporate compliance program or Code of Conduct.
  • In consultation with the CEO, submits mandatory notification of known or suspected corporate compliance violations to the appropriate regulatory agencies.
  • Develops and maintains up-to-date knowledge of corporate compliance requirements and related laws and regulations as mandated or recommended by OIG, CMS, and other agencies; attends outside corporate compliance trainings provided by NACHC and/or other agencies as directed by the CEO.
  • Oversees a corporate wide risk management program, develops, and maintains a written corporate risk management plan and annual evaluation of the plans’ effectiveness.
  • Develops and maintains policies and procedures related to the corporate risk management program.
  • Participates in all safety meetings.
  • Oversee and review emergency measures and programs.
  • Review incident reports and conducts follow up investigations as warranted.
  • Develops and oversees processes for internal incident reporting.
  • Investigates and evaluates claims and potential claims.
  • Oversees a corporate wide patient safety program, develops, and maintains a written patient safety plan and annual evaluation of the plan’s effectiveness and develops and maintains policies and procedures related to the patient safety program.
  • Collaborates with the Chief Medical Officer (CMO) in the investigation of clinical events.
including sentinel events, sentinel event near misses, and significant adverse events; leads and/or participates in the development of root cause analyses as directed by the CMO.
  • Participates in the development of meaningful dashboards and other innovative data visualization tools to track process and outcome measures.
  • Assists in preparing quarterly quality, risk, and compliance BOD reports. Participates in report presentation to the BOD, when requested.
  • Prepares the Continuous Quality Improvement (CQI) meeting agenda, minutes, and maintains the work plan calendar assuring reports by responsible staff are kept timely and in accordance with the annual work plan.
  • Assists with the development, implementation, and maintenance of quality, risk, and compliance operating procedures.
  • Collaborates with senior and executive level staff in assuring all contracts are managed and providers/vendors adhere to the contractual requirements.
  • Collaborates with senior and executive level staff in assuring all critical vendor relationships have signed business associate agreements (BAA’s) as appropriate.
  • Coordinates and completes significant special projects independently or in cooperation with other groups, team members, or directors/managers.
  • Maintains and protects sensitive and private information by keeping patient records confidential in accordance with FQHC, HRSA, HIPAA, local, state, and federal laws, and regulations.
  • Oversees the administration and evaluation of the client satisfaction survey.
  • Accepts and responds to questions from staff regarding FQHC and HRSA reporting data.
  • Keeps up to date with the UDS clinical performance measurements according to HRSA.
  • Serves as a system administrator for the PolicyPlus documents management, credentialing, and Total330 modules.  Runs reports and works with staff to update and upload documents within the system per due dates assigned through the system.
  • Develop an effective compliance/risk management training program, including appropriate training curriculum for introductory training of new employees as well as ongoing training for all employees and managers.
  • Collaborates with CMO and clinic providers to develop and track follow-up and, as applicable resolution to investigations and other issues generated by peer review and/or chart audit activities, including development of corrective action plans, as needed.
  • Support Cempa in developing and implementing the necessary teams, tools, and care process changes to improve patient outcomes and develop innovative approaches to primary care delivery reform.
  • Participate in organization committees and subcommittees when deemed relevant to assure compliance with the organization’s quality, risk management, and compliance programs.
  • Research and develops quality improvement programs to provide services that lead to better healthcare outcomes.
  • Generates reports from EMR, as needed.
 
JOB QUALIFICATIONS AND SKILLS:
 
  • Demonstrate multi-cultural sensitivity and experience or interest in working with underserved communities. Able to interact with a variety of people with a broad understanding of culture, beliefs, and economic levels.
  • Strong knowledge of CQI tools and techniques and ability to perform data analytics.
  • Strong knowledge of healthcare clinical fundamentals, patient safety standards, and performance improvement standards.
  • Agreement with and commitment to upholding the organization’s Principles, Core Values, pledge of confidentiality and the organization’s policies and procedures.
  • Must be well organized, detail-oriented, with excellent computer skills.
  • Able to exercise sound judgment in a variety of situations, with strong written and verbal communication, administrative, and organizational skills, and the ability to maintain a realistic balance among multiple priorities.
  • Ability to work in difficult, stressful, and occasionally threatening situations.
  • Ability to prioritize and organize workload, multi-task, adapt quickly to change and deliver under pressure.
  • Demonstrated ability to work independently and as part of a team in a time-sensitive environment.
  • Must possess advanced grammar, and spelling knowledge skills for executive correspondence, meeting minutes, and staff communication.

 
Position: Quality, Risk Management and Compliance Officer
Organization: Cempa Community Care
Location: Chattanooga,  TN 
United States
Salary: 64,285-79,250
Posting Start Date: 5/19/2021
Date Posted: 5/19/2021
Requirements JOB QUALIFICATIONS AND SKILLS:
 
  • Demonstrate multi-cultural sensitivity and experience or interest in working with underserved communities. Able to interact with a variety of people with a broad understanding of culture, beliefs, and economic levels.
  • Strong knowledge of CQI tools and techniques and ability to perform data analytics.
  • Strong knowledge of healthcare clinical fundamentals, patient safety standards, and performance improvement standards.
  • Agreement with and commitment to upholding the organization’s Principles, Core Values, pledge of confidentiality and the organization’s policies and procedures.
  • Must be well organized, detail-oriented, with excellent computer skills.
  • Able to exercise sound judgment in a variety of situations, with strong written and verbal communication, administrative, and organizational skills, and the ability to maintain a realistic balance among multiple priorities.
  • Ability to work in difficult, stressful, and occasionally threatening situations.
  • Ability to prioritize and organize workload, multi-task, adapt quickly to change and deliver under pressure.
  • Demonstrated ability to work independently and as part of a team in a time-sensitive environment.
  • Must possess advanced grammar, and spelling knowledge skills for executive correspondence, meeting minutes, and staff communication.
 
EDUCATION AND EXPERIENCE:
 
  • Bachelor’s degree in a health-related field required; Master’s degree in a health-related field preferred.
  • 5-7 years of experience in Quality Improvement in a health care setting, preferably a FQHC or FQHC LAL
  • Certifications are a plus:  CPHQ, AAPC CPCO, CHCO, ECRI Risk Management Certificate
  • 2-3 years’ experience in risk management and corporate compliance
  • Proficient in Microsoft Office (Outlook, Word, Excel, and PowerPoint), Adobe Acrobat.
  • Experience with Electronic Medical Records systems a plus.
  • Knowledge and understanding of FQHC, HRSA, HIV/AIDS, HAB
  • Moderate background with OSHA regulations
Status: This listing expires on: 7/18/2021
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Organization Information
Name:
Cempa Community Care
Address:
1000 East 3rd Street

Chattanooga,  TN 37403
United States
Email:
alloyd@cempa.org
Phone:
(423) 648-9916
Fax:
Contact:
Akil Lloyd