Vice President of Quality and Compliance Management

Additional Job Details:

Department:Compliance
Reports To:President of Achieva Support
FLSA Status:Exempt
Salary: $85000
Work Schedule:Full-Time 37.5 hours per week

Make a Meaningful Impact

Are you a mission-driven individual looking to make a difference in someones life Achieva is seeking caring compassionate and reliable individuals to support people with disabilities in achieving independence connection and personal fulfillment. If you value flexibility empowerment and community-centered work we welcome you to apply.

About Achieva

For over 70 years Achieva has been committed to supporting and including individuals with disabilities and their families. We envision a community where everyone leads a life of personal significance. Achieva provides personalized services and opportunities that respect each persons unique aspirations.

Position Summary

This position will ensure Achieva Support programs are in compliance with long-term support and services government laws regulations funders and agency standards. Responsible for developing and maintaining Achieva Support program policies and procedures to ensure compliance to mandates. Oversees Achieva Supports Clinical Team Training Team and is responsible for Achieva Supports Incident Management and Quality Assurance processes. Facilitates annual state quality assessment improvement (QAI) audits. Participates and provides support to Achieva Support annual state licensing and private funder audits. The Quality and Compliance Vice President will be knowledgeable about all government and industry regulations and will identify regulations that are not being adhered to and will advise appropriate leadership. The Vice President of Quality and Compliance Management will directly report to the President and Senior Vice President of Achieva Support.

Key Responsibilities

• Immediate supervisor implement the approved plan or strategy and provide continuous monitoring and updates to the plan as directed by the immediate supervisor

• Ensure the organizations compliance with all external regulations related to performance and quality improvement including but not limited to Health Insurance Portability and Accountability Act (HIPAA) Office of Developmental Programs (ODP) Occupational Safety and Health Administration (OSHA) Office of Child Development and Early Learning (OCDEL) and Center for Medicare and Medicaid Services (CMS). Leads Community Supported Livings Performance-Based Contracting activities

• Plans coordinates and directs quality initiatives designed to ensure quality control and quality assurance of program services consistent with established standards

• Use metrics to provide support in linking projects to strategic operational objectives

• Develops initiates maintains and revises policies and procedures for program offices to ensure compliance with applicable rules and statutes and with the goal of promoting consistency across Achieva Support departments to the extent appropriate and practicable

• Maintains current working knowledge of Federal and State regulations and policies as they affect through routine review of various standards (such as Pennsylvania Code Bulletins etc.) Federal Register notices applicable government and/or industry related internet information sites multiple stated Medicaid manuals and multiple State and Local regulations

• Mentors executive/program leaderships understanding/knowledge of key government and funder regulations and guidance and training to employees on compliance-related matters

• Oversees and facilitates annual state quality assessment improvement (QAI) audits collaborating with Achieva and Achieva Support program departments as needed

• Provides government and/or funder monitoring/inspection support to Achieva Support program offices as needed

• Develops and implements audit corrective action plans as needed

• Collaborates with other departments (e.g. Human Resources Finance etc.) to direct compliance issues to appropriate management for investigation and resolution

• Identify organizational and/or program strengths and weaknesses develops recommendations for approval

• Provides reports on a regular basis and as directed or requested to keep senior management informed of the operations and progress of compliance efforts

• Works in conjunction with Achievas Compliance Team to ensure Achieva Support policies align with Achievas Family of Organizations policies and mandates

• Collaborates and interprets key points for/with Achieva departments (e.g. Information Systems Finance etc.) on critical policy reviews and updates Achieva/Achieva Resource/Achieva Support policies as requested that affect multiple corporate areas

• Acts as an independent review and evaluation body to identify compliance issues/concerns within the Achieva Support organization are being appropriately evaluated and resolved

• Analyzes government and/or public policy and alert the organization to trends and risks

• Oversees Achieva Supports Incident Management operations; implementing corrective action plans and conducting root cause analysis for trended risks

• Secures Pennsylvania quality manager certification; develops and maintains Achieva Supports quality management plan; providing ongoing review and revision as needed

• Oversees Achieva Supports Training program and works with Human Resources Department and others as appropriate to develop an effective compliance training program including appropriate introductory training for new employees as well as ongoing training for all employees and managers

• Oversees the Achieva Support credentialing administration process within the Achieva Support Training department

• Maintains Achieva Supports service qualification with state offices and private funders working in collaboration with Achieva offices to secure service qualifications

• Communicates comments/concerns regarding proposed program policies or impending implementation of program policies to the immediate supervisor

• Establishes and provides direction and management of a compliance reporting system Hotline or other centralized mechanism for compliance issue reporting

• Develop and implement performance improvement initiatives to meet business objectives

• Establishes metrics to monitor financial savings as compared to established goals and targets; i.e. utilization etc

• Institutes and maintains an effective quality and compliance communication program for the organization including promoting (a) use of Compliance reporting system Hotline; (b) heightened awareness of Standards of Conduct and (c) understanding of new and existing compliance issues and related policies and procedures

• Represents internal and external committees related to Compliance and quality improvement

• Develops initiates and maintains effective programs for workforce retention promotion and succession planning within the Quality/Compliance program. Identifies assesses and develops successors and/or identifies the need for potential external candidates to succeed themself and direct reports. Be dedicated to the development of successors and people who have the potential for further responsibility. Ensures plans are in place for short-term continued operations. Identifies work assignments for further learning and development of employees. Reviews and updates the succession plan annually

• Performs other related duties as assigned. This job description is not designed to cover or contain a comprehensive listing of activities duties or responsibilities that are required of the employee for this internship. Duties responsibilities and activities may change at any time with or without notice

Qualifications

• Seven plus years industry related experience in health and human services (BA/BS or-four years industry related experience in health and human services (MA/MS)

• A Background in Title XIX Medicaid and Medicare regulations and reimbursement and a basic understanding of fraud and abuse rules and neglect abuse rules

• Excellent interpersonal analytical and leadership skills necessary plus demonstrated ability to work with a wide variety of constituent groups

• Familiarity with the operation financial quality assurance human resources procedures and regulations required

• Knowledge of best practices in the field of community support for people with disabilities

• Requires sound reasoning good judgment and decision-making skills

• Must meet ACT 33/34 requirements

• Valid Pennsylvania drivers license and vehicle available for work required

Work Environment & Requirements

• Hybrid or remote work flexibility may be available based on organizational needs

Why Join Achieva

Meaningful Work:Directly contribute to the lives of people with disabilities
Inclusive Culture:Be part of a values-driven supportive team
Comprehensive Benefits Include:

• Health Dental and Vision Insurancewith low employee contributions

• Company-Paid Life AD&D and Long-Term Disability Insurance

• 403(b) Retirement Planwith employer contributions after one year

• Employee Assistance Programfor personal and family support

• Generous Paid Time Off and Holidaysfor work-life balance

Our Commitment to Inclusion

Achieva is an Equal Opportunity Employer (EOE) and is committed to creating a workplace and community where all individuals feel respected included and valued. All qualified applicants will receive consideration without regard to race color religion sex age disability sexual orientation gender identity or expression national origin veteran status or genetic information.

We are dedicated to providing access equal opportunity and reasonable accommodations for individuals with disabilities in employment programs and activities. To request an accommodation contact Human Resources at ext. 650 or