Upstate Family Health Center, Inc. · 2 weeks ago
Director of Quality, Risk Management, and Compliance
Utica, NY
Full-time
Onsite
Lead/Staff, Director/Executive
$100K/yr - $120K/yr
3+ years expUpstate Family Health Care Inc. is a Federally Qualified Health Center (FQHC) expanding in the Mohawk Valley. The Director of Quality, Risk Management, and Compliance is responsible for overseeing all activities related to quality improvement, risk management, and regulatory compliance, ensuring high standards of care and adherence to applicable laws.
CharityHealth CareNon Profit
Responsibilities
Develop, implement, and manage the organization's Quality Improvement (QI) program to enhance patient care and operational efficiency
Monitor and evaluate clinical performance indicators and patient outcomes
Facilitate and lead QI initiatives, including setting goals, developing action plans, and tracking progress
Conduct regular audits and assessments to ensure compliance with internal policies and external regulations
Working knowledge of a comprehensive health quality program (e.g. patient safety, peer review, and infection control)
Ensure accomplishment of organization's mission through creating infrastructure that enhances clinical and quality outcomes
Ensures continuous improvement by evaluating and making recommendations considering market demands, regulatory standards and clinical practice
Work closely with CMO and key stakeholders to ensure all clinical and quality metrics are accomplished
Ensure that Quality Improvement Compliance standards are met for all major grants and funders (FQHC/HRSA, FTCA, DHH/HRSA (Ryan White), HHS, etc.)
Work closely with Grants Manager and assist in grant writing for new funding sources and competitive and non-competitive grant renewals for continued funding
In coordination with CMO, develop, implement and enforce clinical policies in accordance with funding requirements
Chair the Quality Management program of UFHC and attend at least one Quality Improvement conference per year
Work with Clinical Leadership and Practice Management to create custom reports needed for ongoing maintenance of quality care and operations
Respond to Ad hoc internal data requests from Leadership
Oversee Clinical Applications to ensure quality and data accuracy and cohesive workflows (i.e. EHR, etc.)
Monitor clinical compliance of medical providers MD, NP, PA and RNs and share findings with Chief Medical Officer (CMO), Senior Director of Clinical Operations, and through regularly generated reporting. (Examples include note closure, proper billing, performance measure feedback)
Responsible for quality incentive programs, CCA, ACO, IPA
Identify potential risks and implement strategies to mitigate them, including the development of risk management policies and procedures
Conduct risk assessments and develop action plans to address identified risks
Oversee incident reporting and investigation processes to identify trends and prevent recurrence
Provide training and support to staff on risk management practices and protocols
Serve as Program administrator for FQHC/HRSA, FTCA, DHH/HRSA (Ryan White), HHS funding grants
Ensure the organization complies with all federal, state, and local regulations, including those specific to FQHCs
Develop and update compliance policies and procedures to reflect changes in regulations and best practices
Conduct regular compliance audits and reviews to identify and address potential issues
Serve as the primary point of contact for regulatory agencies and manage compliance-related correspondence and documentation
Lead and mentor the Quality, Risk Management, and Compliance team to foster a culture of continuous improvement and accountability
Collaborate with other departments to integrate quality, risk management, and compliance efforts into overall organizational operations
Develop and deliver training programs to educate staff on quality improvement, risk management, and compliance matters
Prepare and present reports on quality, risk management, and compliance activities to senior management and the Board of Directors
Communicate effectively with staff, patients, and stakeholders regarding quality, risk, and compliance issues
Stay current with industry trends, best practices, and regulatory changes to ensure the organization remains up-to-date and compliant
Administer and analyze annual Patient Satisfaction Survey
Coordinate quarterly Continuing Quality Management Committee and monthly Sub-committees
Coordinate and Manage Quality Improvement Projects
Present Monthly reports to the QPI Committee of the Board and Quarterly updates to the Board of Directors which include key Data Reports, progress reporting on Quality Improvement Projects, annual updates on UDS and Pt Satisfaction Survey, and other key Quality Improvement/Assurance activities
Develop, update, and maintain Quality Improvement/Assurance and Clinical Application Policies and Procedures and present to the Board of Directors for review and approval as needed
In coordination with CMO design and administer biannual peer-to-peer chart reviews
Coordinate with Risk Management to design and implement Quality Improvement Projects in response to risk events
Ensure timely submission of monthly and quarterly data progress reports required by funders
Work with Clinical Leadership and Practice Management to great custom reports needed for ongoing maintenance of quality care and operations
Respond to Ad hoc internal data requests from Leadership
Oversee Clinical Applications to ensure quality and data accuracy and cohesive workflows (i.e. EHR, etc.)
Monitor clinical compliance of medical providers MD, NP, PA and RNs and share findings with Chief Medical Officer (CMO), Senior Director of Clinical Operations, and through regularly generated reporting. (Examples include note closure, proper billing, performance measure feedback)
Qualification
Required
Master's degree or higher in a field related to leadership or a specific clinical specialty
Certification in their Provider discipline
No less than 3 years of experience in a leadership position in healthcare, preferably an FQHC
Interpersonal skills which allow effective interaction with clients and multiple providers while maintaining a spirit of hope and empathy
Proficiency in Microsoft Office Suite
Proficiency in Electronic Health Records (EHR)
Familiarity with regulations governing healthcare and practice scope
Experience working in Quality Assurance, Risk Management and Compliance
Preferred
Previous Supervisory/managerial Experience Is Preferred
Experience working with a non-profit community health center is preferred
Experience working with clinical informatics databases containing Protected Health Information
Company
Upstate Family Health Center, Inc.
Upstate Family Health Center, Inc.
51-200 employees
Funding
Current Stage
Growth StageCompany data provided by crunchbase