Pace-Quality And Compliance Manager

Apply to 500+ LinkedIn Jobs Automatically

PACE is a Program for All - Inclusive Care for the Elderly. PACE of Northeast Florida is part of the PACE National Association.

Works under the direction of the Executive Director to organize and monitor a Quality Improvement and Performance Improvement Plan (QI) for PACE Place and is responsible for developing the QI annual plan and guiding the implementation of the plan. This position is responsible for collecting data from all sources; tracking, analyzing, and trending the data; and creating reports to be shared with all stakeholders. The Quality Improvement Manager assists in the review process to evaluate and resolve medical and non- medical grievances by participants, their family members, or representatives. In addition, the Quality and Compliance Manager is responsible for the development, implementation, and day-to-day operations of an effective compliance program to ensure our current and future policies/processes meet all governmental regulations. The Compliance Manager will review and evaluate existing company policies/processes for effectiveness, identify gaps or areas that need improvement, and recommend changes to reduce or eliminate compliance issues. The Compliance position is an independent position focused on compliance and will therefore not serve in operational areas.

I. Qualifications and Requirements:

• Registered Nurse (RN), BSN preferred with a minimum of 1 year experience or MSW or LCSW, or BSW with a minimum of 1 year experience

Master’s Level degree is helpful

• Health Care Quality Assurance Certification (CPHQ) or training preferred.
• Current driver’s license, proof of auto insurance, and reliable transportation

II. Experience:

• Minimum of 1 year in a Quality Improvement or like position at a managed care company or healthcare provider

· Have 1 year of experience working with a frail or elderly population OR, if the individual has less than 1 year of experience but meets all other job requirements, the candidate must receive appropriate training from the PACE organization on working with a frail or elderly population upon hiring.

• Training and/or experience working with PACE, MA, MA-PD or PDP programs. 1 year preferred.
• Training and/or experience working with regulatory authorities.
• RN/LNHA/compliance certification preferred.

III. Skills and Knowledge:

• Knowledge of quality management techniques and methods that measure and improve services and service delivery
• Knowledge of compliance and privacy laws and regulations related to health care systems.
• Knowledge of federal and state health care laws and practice acts
• Ability to coordinate and effectively lead groups.
• Ability to work in an interdisciplinary team and multi-ethnic community.
• Ability as an educator, willing to share information, and serve as a mentor to other staff.
• Ability to bridge the communication and technical gap with diverse individuals.
• Self-starter with strong organizational, detail oriented and with good time management skills
• Strong analytical skills
• Able to plan and problem solve.
• Computer literate (MS Word, Excel, PowerPoint, Access, and Outlook)
• Excellent written and oral communication skills
• Strong leadership abilities
• Articulate team player with the ability to lead projects, positively influence others, and successfully manage quality program.

Job Type: Full-time

Benefits:

• 403(b)
• Health insurance
• Paid time off

Work Location: In person