Director of Quality and Compliance

Job Summary

The Compliance Officer is a highly detail-oriented healthcare professional who combines healthcare industry knowledge, technology experience, and compliance expertise to ensure the organization follows all laws governing healthcare information. The primary focus will be to identify and mitigate compliance risks, conduct audits and reviews, and provide guidance to staff with a certain level of quality assurance. Additionally, this position will function as UAII's privacy officer, overseeing the development, implementation, maintenance of, and adherence to privacy policies and procedures regarding the safe use and handling of protected health information (PHI) in compliance with Federal and State Health Insurance Portability and Accountability Act (HIPAA) regulations.

Job Duties & Responsibilities

Risk Management

-Review incidents, claims, and liability reports to identify risks in the organization.
-Prevent patient privacy breaches.
-Educate and provide solutions to employees about risk, liability, and risk management policies and procedures.
-Create a risk management plan to help avert future problems, including internal risk assessments.
-Reviews hospital and medical malpractice and liability insurance.
-Monitor other staff in the organization to ensure compliance.
Quality Assurance

-Develop and implement comprehensive quality assurance policies and procedures.
-Monitor and assess compliance with healthcare regulations and standards.
-Maintains a safe and healthy work environment by following standards and procedures and complying with legal regulations.
-Prepare and present analytics to the leadership team.
-Audit department records and processes related to the general department functions, including but not limited to billing, training, credentialing and privileging, patient upkeeping, and regulatory documents.
Compliance

-Oversees healthcare compliance programs promoting ethics and integrity in clinical processes and procedures.
-Develop a plan of action for any relevant compliance metrics.
-Responsible for managing adherence to federal and state laws, regulatory guidelines, and Medicare and Medicaid Service requirements, including OIG requirements.
-Review and relay all regulatory documents.
-Develop policies and procedures that comply with federal and state regulations.
-Provide departmental guidance to healthcare units regarding their specific compliance requirements.
-Perform other related duties as assigned.

-Five (5) years of experience in compliance or in other related fields.
-Experience working with nonprofit organizations, community groups, and
performance-based government contracts.
-CHC (Certification in Healthcare Compliance), CHCP (Certification in -
Healthcare Privacy Compliance), CHRC (Certification in Healthcare Research)
-A combination of experience, education, and training may substitute for
degree requirements on a year-for-year basis.