The Quality and Compliance Coordinator:
- Responsible for the oversight and administration of the Compliance Program and QI for the assigned PACE Program. This includes compliance with all state and federal program requirements, obtaining and maintaining certification under CMS and any other state or federal laws.
- Maintains a working knowledge of applicable Federal, State, and local laws and regulations, as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical and professional behavior.
- In collaboration with Quality and Compliance Manager and Medical Director, initiates, develops, and guides the implementation of the annual Quality Improvement Plan. Timely compiles quarterly and annual reports and presents the reports to the PO leadership, staff, contractors, administration, the Participant Advisory Committee (PAC), and Board of Directors in accordance with the Compliance Plan and the QI.
- Schedule and lead the Pace Quality Management Committee in collaboration with the Medical Director at assigned PACE Program. Duties include preparation of meeting agenda, preparation of minutes, and assistance with committee correspondence and presentation materials.
- Communicate the QI to members, staff, contractors, administration, Participant Advisory Committee (PAC), and the Board of Directors..
- Ensure compliance with CMS regulations. Responsible collaborating with the Health Plan Operations Manager on the Medicare Part D fraud, waste and abuse Compliance Program.
- Prepare for CMS sites visits, inspections, and all subsequent follow up
- Other duties assigned
Position Requirements:
- Must possess a comprehensive knowledge of healthcare delivery, compliance and management at a level as normally obtained through a Bachelor's Degree in Nursing or other closely related field.
- Three (3) years of documented experience working in the field of quality and compliance for a healthcare organization preferred.
- Minimum of one (1) year of documented experience working with a frail or elderly population preferred.
Empath Health values diversity as it strengthens our community and care. We embrace the diversity of cultures, thoughts, beliefs and traditions of our employees, volunteers and people we are honored to serve across our network. Our diverse staff reflects our community and each day, we work to be respectful, sensitive and competent with each other and those in our care. In every journey, we are dedicated to achieving comfort, dignity and exceptional care. Those of all backgrounds are welcome and encouraged to apply with us or seek our care and services.Our commitment to patient, client, staff and volunteer safety is a cornerstone of a High Reliability Organization with a focus on zero harm. Participation in the seasonal influenza is a condition of employment and a requirement for all Empath Health employees.Providing compassionate, full life care is an honor we take seriously at Empath Health. Join our team and make a positive impact in the community!