"Alerted.org

Director of Compliance Quality & Risk Management

NY

Job Type

Full-time

Description

Director of Compliance Quality & Risk Management Affiliate Wide

Planned Parenthood of Central and Western New York (PPCWNY) protects and provides health care and education that empowers individuals and families. With respect. Without judgment.?No matter what.

In support of PPCWNY’s mission, the Director of Compliance, Quality, & Risk Management (CQRM) has responsibility for developing, coordinating, and implementing the agency-wide CQRM program in collaboration with the heads of all departments including Patient Services, Finance, Revenue Cycle, Human Resources, Development, Information Technologies, and Grants & Programs. The Director of CQRM ensures that uniform standards of quality services are met in all PPCWNY health centers and throughout the affiliate and that the CQRM program and policies are in accordance with all Planned Parenthood Federation of America (PPFA), PPCWNY, healthcare (corporate) compliance, and federal and state regulatory agencies’ standards and guidelines. The Director of CQRM will work to ensure participation of all staff in the reporting of potentially harmful conditions to create a “Just Culture” environment, and promote continuous, innovative improvement.

Essential Functions

+ Review and update existing, as well as develop new manuals, policies, procedures, protocols, and forms in accordance with PPFA standards and guidelines, federal and state guidelines, and PPCWNY requirements in areas including but not limited to:

+ Exposure Control

+ Infection Prevention

+ HIPAA Privacy

+ Health Care Compliance

+ Records Retention/Destruction.

+ In collaboration with agency leadership, ensure that all federal, state, local and PPFA compliance requirements are included in the CQRM workplan and met.

+ Ensure that mandatory and other in-services, including, but not limited to HIPAA, OSHA, corrective action needs, Infection Prevention, etc. are offered and are completed by required staff.

+ Manage the accreditation and corollary processes for PPFA.

+ Assist with organization of documents for Article 28, Title X, OMIG, third party payer, and other on-site review processes.

+ Serve as the Agency’s HIPAA Privacy Officer. In collaboration with the HIPAA Security Officer, and the Medical Records Consultant, design and implement PPCWNY’s HIPAA policies, procedures, and processes, including determining “need to know” information for staff, staff training about HIPAA, record request and retention/destruction processes, and review and monitoring of organizational compliance.

+ Serve as the Agency’s Health Care (Corporate) Compliance Officer. Develop and manage the affiliate Health Care (Corporate) Compliance program, including creating compliance policy and procedures, monitoring compliance, and reporting compliance deficits to the President and CEO. Coordinates internal investigations and pursues corrective actions with all internal departments, contractors, agents, subcontractors, independent contractors, and the State.

+ Develop trainings for staff, including activities for Corporate Compliance & Ethics Week (each November).

+ Review all legal correspondence regarding patient services and operations, and initiate discussion with Medical Director, VP of Health Services, President and CEO, and Agency, as well as PPFA counsel, as needed.

+ Oversee the Incident Management system (AIMS), follow-up with staff and supervisors, as needed, in order to investigate, develop, run, and assist with Root Cause Analyses and Plan-Do-Study-Act cycles, as well as Corrective Action Plans as needed.

+ Coordinate all quality improvement activities including on-site audits.

+ In collaboration with the Medical Leadership Team, provide ongoing training and develop training tools for all health center staff on quality improvement as it relates to clinical practices.

+ Provide training and serve as a resource for agency leaders and staff on how to use the Model for Improvement and Plan-Do-Study-Act cycles to make meaningful changes.

+ Write and present reports summarizing compliance issues, quality improvement activities, and risk mitigation activities for staff training, leadership awareness, Board of Directors (BOD) knowledge and per PPFA, NYS Department of Health, US Health and Human Services and other agency requests. The Director of CQRM is accountable to the BOD and shall report compliance concerns directly during a board meeting’s executive session.

+ Show respect to all internal and external customers for differences in backgrounds, lifestyles, viewpoints and needs.

Supervisory Responsibilities

+ Build the CQRM team necessary to manage the agency’s CQRM needs as well as being prepared for projected organization growth, including department succession plans and supervises the department.

+ Ensure that the responsibilities, authorities, and accountabilities of all direct reports are well defined and understood.

+ Provide ongoing coaching, training, and support, as well as contribute toward creating an atmosphere that encourages open and direct communication for department.

+ Act as a CQRM resource to staff in other departments regarding CQRM-related responsibilities.

Other Accountability Activities

+ Oversee the CQRM Committee and chair CQRM Committee meetings, coordinate the development and implementation of the Agency’s CQRM annual work plan, risk analysis and mitigation strategies and ensure the program is agency-wide.

+ Participate in organization committee work, as appropriate.

+ Support and participate in affiliate initiatives.

+ Perform other duties as required and assigned.

Requirements

Qualifications Applicants mustpossessthe following qualifications (or equivalent combination of education and experience):

Education

+ Bachelor’s Degree in a Healthcare, Administration, Management, Engineering or other-related field, or equivalent combination of education and relevant experience

Experience

+ Minimum of five (5) years progressive clinical and/or administrative experience with quality and compliance focus.

+ Experience in health care credentialing and privileging procedures, and electronic health records, billing compliance and/or financial auditing strongly preferred.

+ Experience in working with regulatory systems (e.g. JCAHO, OMIG, IPRO, NYS DOH, etc.)

Certifications, Licenses, Registrations

+ Certification in Quality Management, Health Care Compliance and/or Healthcare Privacy Compliance, Project Management, Lean Six Sigma or equivalent preferred.

+ RN, NP or PA, a plus.

Knowledge, Skills, & Abilities

+ Knowledge of OSHA, CLIA, HIPAA, NYS Article 27-F and 28, federal Title X family planning grant program, the NYS DOH 318 STI program, medical records documentation and release, corporate compliance, and related guidelines and requirements preferred.

+ Proficiency with Microsoft Office suite of products.

+ Demonstrated experience building an inclusive and respectful organizational culture that leverages diversity.

+ Strong project management, follow-through, and leadership skills.

+ Ability to build effective work teams with diverse staff.

+ Excellent communication skills (verbal and written).

+ Ability to write publication-ready reports and give oral presentations.

+ Excellent organizational skills and attention to detail.

+ Ability to work a flexible schedule.

+ A commitment to Planned Parenthood of Central and Western NY (PPCWNY)’s mission, vision and values along with a commitment to providing services to a diverse range of clients and to the goals of PPCWNY is essential

Working Conditions

+ Standard Health Center and office environment

+ Well-lit/ventilated

Physical Requirements

+ Ability to lift 10 pounds with or without accommodation.

+ Possess sufficient mobility to perform the Essential Functions listed in this Job description with or without accommodation.

+ May experience visual fatigue working at a computer with potential extended periods of sitting.

+ Ability to travel to all agency locations as assigned.

Work Schedule This position is full-time (40 hours per week). Regular schedule will be Monday – Friday with occasional evenings and weekends.

Benefits & Compensation At PPCWNY, we are committed to equitable compensation practices and transparency. In alignment with these efforts, the pay for this position ranges from $84,364 to $107,806/year. Actual compensation will be determined by experience and other factors permitted by law. In addition to competitive compensation, PPCWNY offers an extensive benefits package with generous Paid Time Off, 10 paid holidays, affordable medical, dental, and vision options, Health Savings Account or Flexible Spending Account, 401(k) with match, and much more!

Planned Parenthood of Central and Western New Yorkisan equal opportunity employer.

Salary Description

$84,364 - $107,806