Transformations Care Network · 5 hours ago

Quality and Compliance Manager

United States

Full-time

Remote

Mid, Senior Level

3+ years exp

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Responsibilities

Serve as project manager for MD Clinic Licensure and accreditation project and subsequent licensure activities in other states within the region as strategic growth plans require.

In collaboration with consultant and market/corporate leadership, ensure all requirements are met for successful accreditation; develop policies, procedures and other supporting evidence and facilitate trainings of all staff on standards.

Oversee annual training program for all market staff and ensure onboarding activities include training requirements for accrediting and licensing bodies.

Develop internal processes and tools to monitor ongoing compliance with standards following initial accreditation.

Use data to monitor compliance, identify issues/risks/opportunities as early as possible and to develop targeted interventions designed to improve or maintain compliance.

Report on status of all aspects of compliance/accreditation weekly.

Develop and monitor quality improvement requirements as required by accrediting body.

Serve as market lead on complaints and grievances, documenting and resolving according to enterprise policy and regulatory and payor requirements.

Serve as market lead on payor and regulatory audits; track and monitor compliance with corrective actions; performance improvement projects etc.

Provide data to market operations director to highlight risks and opportunities for operational improvements.

Maintain market specific grids/tools regarding licensure and supervision requirements; update and educate teams as rules/regulations are modified.

Key metrics for evaluation include (examples, actual metrics to be developed):

Successful accreditation- initial survey

Successful re-accreditation- repeat survey

Treatment plan completion/compliance

Qualification

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Healthcare OperationsProject ManagementBehavioral Health KnowledgeData Analysis