IDD Quality Assurance & Compliance Director

Description

Location: Middletown NY

Salary: $66300 Annually Benefits Package

Hours: Monday-Friday 8:00AM-4:30PM (40hrs)

OVERVIEW OF PRIMARY RESPONSIBILITES:

This position supervises the daily QA/QC Quality Improvement Regulatory Safety and Compliance activities that support all corporate operations including reviews investigations audits surveys process improvement activities training and risk management for the Access Network inclusive of Access: Supports for Living NY Families for Autistic Children Meaningful NY and The Guidance Center of Westchester. Ensures compliance with all local state and federal rules and regulations including but not limited to those mandated by OPWDD and NY State Justice Center.

PRIMARY FUNCTIONS:

Quality Management

• Leads the development implementation and evaluation of the monthly audit program plan including monthly QA and UR work plan audits ensuring quality QA audits are scheduled and completed

• Developing and managing tracking tools on QA functions audits regulations

• Work collaboratively with staff and leaders to develop implement and track quality work plans and plans of correction on all internal and external audits

• Lead QA/program annual meetings and protocol review.

• Leads and provides oversight on the development of Quality Assurance department activities of Internal QA regulatory review audits QA Monthly Reports Billing Grids Documentation Curriculum Program Personnel Regulation Tracking Annual Program Review Meetings Forms Protocol and Tracking Electronic Health Care Records

• Lead the annual review of all program and QA protocols

• Assist in developing and implementing strategic communications across departments related to rule changes audit findings and regulatory requests by stakeholders

• Assist the Vice President Risk Management Quality and Compliance in ensuring quality related deliverables are achieved across all business segments by assessing gaps monitoring performance and working with key leaders to implement solutions.

• Lead in ensuring quality related deliverables are achieved across all IDD services for QA audits

Incident Management

• Co-Chair the Incident Review Committee meeting ensuring IDD incidents are reported tracked investigated presented to committee preparation of meeting agendas and review and approve minutes

• Oversight/development of Quality Assurance department activities of Incident Reporting Processes Investigations Incident Management OPWDD (IRMA) Monthly Incident Reports to leaders and Maintain Incident electronic files

• Establish and maintain effective communication and relationships with legal representatives regarding incidents

• Facilitate the Incident Management as to collect organize analyze prepare and manage quality committee dashboards agendas meeting minutes and reports for committees and the Board of Directors.

• Initiate provide support and monitor strategic projects managed by Quality Specialists and ancillary staff

Corporate Compliance

• Leads with direct oversight to the ASFL Network wide corporate compliance program.

• Leads the development updating and executing all elements of the Corporate Compliance Policies Protocols and Annual Work Plan

• Co-Chairs the Compliance Committee conducting compliance investigations publishing regulatory guidance updates identifying compliance risk areas conducting Rapid Improvement Events (RIEs)

• Ensure Corporate Compliance trainings are inclusive of all current regulations and guidances for new employees board members and the annual compliance training

• Prepare the annual and semi-annual Corporate Compliance report for committee Leadership and Board of Directors.

Accreditation

• Assist in organizing and managing external reviews across the organization. This includes leading accreditation surveys (CQL or others as applicable) monitoring reports managing mock surveys and conducting drills completing audits reviews and investigations.

• Train and support QA staff for all quality related tasks including Proactive Risk Assessments A-3 Thinking Project Management Gap Analysis Investigations Data Analysis Conducting Experiments Utilization Reviews and QA Audits.

• Attend and participate in internal and external meetings related to quality regulatory and compliance requirements as needed.

Leadership and Management

• Train supervise and evaluate performance of assigned staff

• Provide staff with the training mentoring and resources necessary to carry out their work

• Ensure adherence to department and organizational standards policies and procedures

• Ensure performance goals expectations and standards are clearly understood by supervised staff

• Evaluate employees performance on an ongoing basis and take appropriate corrective action if needed

• Perform talent management functions in collaboration with Human Resources

Supports Quality Assurance Departments in:

• Safety and Security: Supports organizational safety and security measures for ASFL Network Safety Committee meetings Site Safety Coordinators monthly walk through inspection fire drills internal and external inspections are completed and logged After Action Review (AAR) are trained implemented documented and tracked. Support the implementation of all Health and Safety related standards of CARF are implemented at organizations

• Risk Management: Supports the development and maintenance of the annual Risk Management Plan & Matrix. Collaborates with value streams prepares consolidated reports conducts SWOT analyses and risk assessments across the system. Assesses and ensures risk mitigation strategies are effectively implemented across the Safety Committee Value Streams QA/Compliance Finance Central Administration and throughout all system policies protocols and plans. As part of the Risk Management Team also has the following responsibilities:

• Privacy and Security: Support the collaboration of the Privacy Security Team Quality Assurance and Information Technology teams assists in building a strategic and comprehensive privacy program. Participate and support the agency Privacy Security Team and HIPAA related tasks that defines develops maintains and implements policies and processes that enable consistent effective privacy practices which minimize risk and ensures the confidentiality of protected health information (PHI) paper and/or electronic across all media types.

• Complaint & Grievance Management: Supports the complaint and grievance protocol and process. Collaborates with agency leadership on open reports investigations required pre and post letters and the closure of grievance reports.

• Project/Process Improvement: Identify opportunities to increase efficiency and standardize daily operations to increase revenue reduce cost and improve the quality of support and services offered by Access: Supports for Living.

• General: As a leader in the Quality Assurance Compliance and Risk Management Teams participates in relevant huddles and meetings. May assist with leading or co-leading the Incident Review Committee Compliance Risk Management and/or Privacy Security meetings including helping to chair sub-committees or complete special projects as needed. Attend and participate in internal and external meetings related to quality regulatory and compliance requirements as needed.

ADDITIONAL FUNCTIONAL / ORGANIZATIONAL SUPPORT:

• Additional duties may be assigned to support the overall quality efforts of the organization

QUALIFICATIONS AND ATTRIBUTES:

• Knowledge of OPWDD Regulations

• Knowledge of New York State Justice Center Regulations

• CMS and Office of Medicaid Inspector General (OMIG) Rules Regulations and Annual Work plans

• Knowledge of NY State Part 521 Compliance Regulations

• Knowledge of HIPAA (the Health Insurance Portability and Accountability Act of 1996)

• Knowledge of HITECH and Omnibus requirements

• Use of standard office equipment such as computers cell phone phones photocopiers and fax machine.

• Moderate to advanced use of Microsoft Word Excel PowerPoint Microsoft Teams WebEx and/ or Zoom remote meeting host and participant tools

• Ability to collect analyze and report data

• Ability to write semi-annual and annual reports including charts and graphs

EDUCATION AND EXPERIENCE:

• Masters Degree of Professional/Business Studies or

• LCSW or LMSW or

• Bachelors degree and at least 5 years of Quality management experience

• At least 2 years of Lean or Lean Six Sigma experience preferred

PHYSICAL CHARACTERISTICS:

• May be subjected to long-periods of sitting or standing

• May have to lift up to 10 lbs on occasion

• Able to work in open space floor plan

• Work alongside co-worker

EEO Employer