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Chapters Health System · 9 hours ago

PACE Quality Specialist

Fort Myers, FL

Full-time

Hybrid

Entry, Mid Level

$60K/yr - $90K/yr

2+ years exp

Chapters Health System is committed to providing outstanding patient care and high-level customer service in the community. The PACE Quality Specialist will support and advance compliance and quality improvement programs in alignment with regulatory requirements, working collaboratively with interdisciplinary teams to promote patient safety and continuous quality improvement.

Health CareHospitalNon Profit

Responsibilities

Support compliance with CMS regulations, AHCA requirements, and PACE program standards, including 42 CFR Part 460

Assist in the development, implementation, and maintenance of compliance policies, procedures, and internal controls

Monitor regulatory updates and guidance from CMS, AHCA, and other governing bodies; communicate changes to leadership and operational teams

Participate in regulatory surveys, audits, and site visits; assist with preparation, coordination, and response activities

Support corrective action plans (CAPs), root cause analyses, and ongoing monitoring of compliance risks

Projects within the PACE Program as needed at the direction of the PACE Director of Compliance and Quality

Proven ability to lead and work through others without direct reporting relationship to achieve business goals

Strong analytical skills balanced with communication skills the ability to understand and create understanding of complex information among a variety of stakeholders and business partners

Demonstrated ability to manage multiple priorities and make appropriate decisions in the face of ambiguity

Demonstrate affinity for challenging work and high responsibility and accountability

Provide leadership, oversight, and monitoring of QAPI program for all areas of the organization

Create connections among project teams to eliminate gaps in process design and implementation

Identify barriers to implementation and develop and propose solutions that address both business needs and customer satisfaction

Research, monitor and report regularly on all State, Federal and Agency regulatory changes

Assist with development of data collection tools and process

Monitor, track and trend data collection. Report results to management. Prepare reports appropriate for distribution at all levels of the organization

Ensure job responsibilities are met, including attendance requirements and prompt arrival at work

Conduct scheduled and ad hoc compliance and quality audits, including medical record reviews, operational audits, and regulatory compliance assessments

Utilize auditing tools, and sampling methodologies to evaluate compliance with clinical, operational, and documentation standards

Analyze audit findings, identify trends, and prepare clear, actionable reports for leadership and committees

Track audit outcomes, corrective actions, and follow-up activities to ensure timely resolution and sustained compliance

Support the organization’s Quality Assessment and Performance Improvement (QAPI) program in accordance with CMS and PACE requirements

Assist in the planning, implementation, and monitoring of QAPI projects using recognized performance improvement methodologies (e.g., PDSA)

Collect, validate, and analyze quality metrics, key performance indicators, and outcomes data

Prepare QAPI reports, dashboards, and presentations for Quality Committees, Compliance Committees, and leadership

Collaborate with interdisciplinary teams to implement quality initiatives that improve participant outcomes, safety, and satisfaction

Monitor and report outcomes of completed QAPI projects

Demonstrate working knowledge of medical terminology, clinical workflows, and healthcare documentation standards

Review clinical records for accuracy, completeness, and regulatory compliance

Support documentation improvement efforts related to clinical assessments, care plans, and regulatory reporting

Provide compliance and quality education to staff as assigned, including audit findings, regulatory requirements, and best practices

Serve as a resource to clinical and operational teams regarding compliance and quality standards

Participate in committees, workgroups, and performance improvement meetings as assigned

Other duties as assigned

Qualification

Healthcare compliance experienceQAPI program managementCMS regulations knowledgeQuality improvement certificationHealthcare auditing proceduresAnalytical skillsMedical terminology proficiencyMicrosoft Office proficiencyProject management skillsCommunication skillsOrganizational skills

Required

Bachelor's degree in business, healthcare administration, Nursing, Public Health, Health Information Management, Quality, Compliance, or a related field required. (Work experience may substitute for educational degree.)

Minimum of 2-3 years of experience in healthcare compliance, quality, auditing, or regulatory oversight

Must possess a valid Florida Drivers' License, current auto insurance, and reliable transportation

Certification of completion of Alzheimer's Disease and Related Dementias Training through the Florida Department of Elder Affairs (or completion within six months of employment)

Strong analytical, organizational, and project management skills

Ability to interpret regulations and translate requirements into operational practices

Excellent written and verbal communication skills

Ability to work independently in a remote or hybrid environment while collaborating effectively with cross-functional teams

Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rate, ratio, and percent and to draw and interpret bar graphs

Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists

Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form

Ability to define problems, collect data, establish facts, and draw valid conclusions

Strong abstract reasoning skills will be used to assess and analyze complex business workflows, processes, and systems

Ability to communicate, concentrate and document effectively and accurately

Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations

Ability to write reports, business correspondence, and procedure manuals

Ability to effectively present information and respond to questions from groups of managers, clients, customers, and the general public