Job description

SUMMARY:
The NC Quality Assurance Manager and Compliance
Liaison (NCQAMCL) reports directly to the Director of Quality Assurance with assigned subsidiary compliance of the management and quality assurance programs which includes the support of the company compliance program as required by federal and state law and corporate guidelines. The NCQAMCL provides leadership regarding identified management concerns by assessing, planning, developing, evaluating, and facilitating the implementation of sound performance improvement initiatives of the respected state programs.
The NCQAMCL implements and oversees quality operations consistent with licensing requirements, ethical best practices, business regulations, and supports the company compliance program. This leader ensures proactive auditing and reporting data analytics are incorporated within the states. The NCQAMCL collaborates and supports the State management team, Clinical Director, and Executive Leader(s) with program monitoring and improving all program operations relating to the quality, safety, and security of consumers and structures in addition to implementing the risk prevention activities.

DUTIES AND RESPONSIBILITIES:

• Communicate effectively with individuals served, staff, parents/guardians, and community contacts, Federal, State, and Local Officials.
• Ensure the integration and implementation of all quality initiatives, assurance policies, procedures, state-specific regulatory requirements, contract stipulations, and accreditation standards such as CARF are maintained.
• Confirm all appropriate quality and compliance reporting systems and forums are in place to foster communication and to establish and maintain a culture of continuous quality improvement and compliance within and between programs, departments, and disciplines.
• Participates actively in all assigned Broadstep Committees. Chairs and/or participates actively in all assigned subsidiary-level committees according to the respective subsidiary committee policies.
• Assists and supports the Chief Compliance Officer and company QA Director with company initiatives.
• Leads investigation related to Grievances, Complaints, and Fraud Waste and Abuse process.
• Monitors for the ongoing implementation and effectiveness of state systems to maintain regulatory compliance.
• Completes related internal and external reports and provides data to the Chief Compliance Officer and others as required.
• Validates survey outcome scores through process reviews in conjunction with Chief Compliance Officer, company QA Director, and staff.
• Serves as a resource in quality and compliance activities and as a survey support system.
• Monitors and supports the quality and compliance team in managing labor costs and staffing.
• Upholds knowledge and ability to implement all facets of the company’s Abuse, Neglect, Exploitation, and Misappropriation policy, including the responsibility of being a mandatory reporter.
• Retains knowledge of all clients’ rights and HIPAA laws, and demonstrates the ability to identify, intervene, and report appropriately when observing a violation.
• Defines, articulates, and develops a strategic plan with regards to the Quality Assurance, Data & Risk Management consistent with the mission, vision, goals, objectives, and format of the organization, and submits the following year’s Plan for approval.
• Ensures the development and annual review of compliance and improvement of subsidiary required operational plans.
• Actively contributes to the planning and development of new programs/services that would expand, horizontally or vertically, the current service offerings, to include the following: (1) submission of development proposal to the immediate supervisor; (2) upon approval, initiation of program model development; and, (3) implementation and execution of the new program services.
• Oversees and understands the subsidiary crisis/emergency plans and applies that knowledge during each test drill and actual crisis situation.
• Knows that abuse (physical, sexual, verbal/psychological), neglect, exploitation and misappropriation, and other code of ethics violations are against the law and company rules of conduct (policies). Additionally, the NCQAMCL will serve as primary representative and must comply with any external (County, State, or Federal) investigation or inspection. NCQAMCL or designee is required to contact state reporting agencies immediately.
• Assists management with writing and reviewing RFPs, RFBs, and CONs, as applicable.
• Ensure programs are meeting quality assurance compliance with all documentation, reporting, and service provisions within all contracts of services within the state.
• Conducts quality assurance and administrative trainings as directed by the Chief Compliance Officer, company QA Director, and the Executive Leadership.
• Works with state leadership in marketing, growth, and business development.
• Assists the state and executive leadership in reviewing and revising compliance and quality policies and procedures.
• Performs other related duties as assigned by the QA Director and/or Chief Compliance Officer.
• Act as liaison between the agency advisory or others as noted. the medical staff and the service lines and establish and attend meetings to provide pertinent information related to the agency operations and the provisions of quality health care.

SUPERVISORY RESPONSIBILITIES:

• There are no direct and indirect reports at this time.

QUALIFICATIONS: Specific requirements include the following:

• Master’s degree in Business Administration or Human Services related fields or equivalent experience; Masters’ degree preferred, or Bachelor’s Degree in Human Service Field and at least five (5) years of health care experience conducting QA or Compliance-related functions.
• Possess a minimum of five (5) years of supervisory experience (preferred); three (3) years of management-level experience required.
• CQI certified or Green Belt, Black Belt, or Lean certification (preferred).
• Meet all licensing requirements set forth by the respective state of operation.
• Experience in auditing, performance improvement and multi-project management.

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