Clinical Quality & Compliance Senior Manager

Cenikor Foundation; Houston (TX); On-site; USD 70,000 - 90,000; Full time

Job summary

A nonprofit organization in Houston is seeking a Clinical Quality & Compliance Senior Manager to oversee clinical quality programs and ensure compliance with standards. The ideal candidate will have supervisory and compliance experience, as well as knowledge in substance abuse treatment. Responsibilities include conducting audits and developing training programs to enhance performance. Competitive compensation is offered, along with the opportunity to make a significant impact in the organization.

Qualifications

• Experience working with various types of people.
• Ability to prioritize multiple tasks.
• Ability to maintain compliance with documentation.

Responsibilities

• Oversee clinical quality programs to support strategic objectives.
• Conduct compliance audits and risk assessments.
• Develop and deliver training programs on compliance.

Skills

Knowledge of substance abuse treatment

EHR software proficiency

Quality compliance knowledge

Time management skills

Oral and written communication skills

Education

Two years supervisory experience

Two years quality or compliance experience

Clinical licensure (LCDC minimum)

Registered Nurse (RN)

Tools

EHR software

Job description

Clinical Quality & Compliance Senior Manager

The Clinical Quality & Compliance Senior Manager is responsible for the oversight and ongoing implementation of the clinical quality programs to support the Foundation’s strategic objectives in regard to clinical documentation, client service and clinical compliance. This includes new team member training on the CQI processes and other clinical support programs. This position will administer and assist with ongoing development of a comprehensive clinical compliance program to improve organizational and individual performance with an emphasis on quality and service to achieve our mission.

• Maintain and track clinical compliance records ensuring all documentation is correct and submitted in a timely manner.
• Ensure Milliman standards are met for clinical documentation.
• Work closely with leadership, QI, training and HR to identify root cause needs and develop solutions for improved clinical and contract performance. Conduct monthly QI and regular compliance audits and risk assessments to identify gaps in clinical quality and address any compliance gaps.
• Conduct New Hire Audits for new clinicians at 30, 60 and 90 days. Develop and maintain clinical standards in conjunction with QI, Clinical Managers and UR departments, ensure consistent documentation.
• Train clinicians on the appropriate documentation areas to increase clinical quality and timeframes.
• Monitor and evaluate training program's effectiveness, success and ROI at regular intervals and report to leadership council.
• Coordinate with regulatory agencies and manage communication regarding compliance issues or inspections.
• Monitor and analyze quality metrics and trends to drive continuous improvement initiatives.
• Develop and deliver training programs on compliance and quality management topics to employees at all levels.
• Ensure staff are aware of compliance and quality requirements and understand their roles in maintaining these standards.
• Act as the primary point of contact for compliance and quality-related inquiries from internal and external stakeholders.
• Collaborate with cross-functional teams to address compliance and quality issues and implement solutions.
• Maintain a keen understanding of clinical trends, developments and best practices.
• Conduct spot audits for compliance in EHR systems and identify training opportunities and gaps based on audit results and data analysis.
• Ensure completion of Big 5 performance management tool by the required deadline and use of SMART goals to support annual performance compensation review.
• Uphold the core principles of Cenikor's culture and create a positive working environment for all team members.
• Perform additional duties as assigned and consistent with the exempt functions as assigned in this job description.

Qualifications for the Position

Skills, Knowledge, and Abilities:

• Knowledgeable about substance abuse treatment, prevention, and aftercare.
• Knowledgeable of insurance, Medicaid, and state funding admissions criteria, level of required documentation and timing.
• Proficient skills in the use of EHR software.
• Knowledgeable of quality compliance.
• Possess good time management skills needed to meet aggressive deadlines and prioritize multiple tasks.
• Presents a professional, positive image.
• Experience working with various types of people.
• Possess good oral and written communication skills.
• Ability to consistently uphold the Core Principles of Cenikor's Culture:
• Demonstrate mission of service to our clients
• Positive, respectful communication with both staff and clients
• Demonstrate self-motivation and perseverance to achieve goals
• Role model appropriate, professional behaviors including appropriate client boundaries
• Work effectively as part of a team, helping to set up others for success

Education:

• Two years supervisory experience.
• Two years quality or compliance experience.
• Sitting in normal position for extended periods of time.
• Reaching by extending hand(s) or arm(s) in any direction.
• Finger dexterity required to manipulate objects with fingers rather than with whole hand(s) or arm(s), for example, using a keyboard.
• Communication skills using the written and spoken word.
• Ability to see within normal parameters.
• Ability to hear within normal range.
• Possible exposure to communicable diseases.
• Ability to drive.
• Ability to travel to facilities by various transportation means up to 20% of the time.

Licensure:

• Clinical licensure required (LCDC minimum).
• Registered Nurse (RN)
• Valid Driver's License required.

• EQUAL OPPORTUNITY EMPLOYER
• DRUG FREE WORKPLACE