PACE Quality & Compliance Leader

SAN-Ysidro-Health; San Diego (CA); On-site; USD 140,000 - 190,000; Full time

Job summary

SAN-Ysidro-Health is seeking a Director of Quality and Compliance for the San Diego PACE program. You will lead the quality improvement and compliance activities, overseeing data management, reporting, and staff training to ensure alignment with CMS, HIPAA, and state/federal regulations.

You will supervise the QI and Compliance teams, work with the Medical Director and IDT, and drive performance improvements through analysis and policy development within a collaborative, regulated environment.

Qualifications

• Bachelor’s degree in health-related field or equivalent relevant experience.
• 3 years of experience in healthcare quality improvement or healthcare compliance.
• Master’s degree preferred in nursing, public health, quality management, healthcare management or related field.

Responsibilities

• Participates as a member of the San Diego PACE Management Team.
• Ensures compliance with State and Federal regulations regarding PACE services; HIPAA Privacy Official responsibilities.
• Manages all aspects of the QAPI program and other review processes, CMS/NPA representation.
• Supervises Quality Coordinator and Compliance Manager; oversees HPMS/CMS reporting.
• Collaborates with Medical Director and IDT to develop standards, indicators and corrective actions.
• Oversees data management for QI activities; analyzes data to improve policies and procedures.
• Compiles statistical data and writes reports/presentations for leadership.
• Represents the PACE program in quality committees; supports governance activities.
• Develops and implements policies, procedures, and training; leads policy development workgroups.
• Leads audits for regulatory agencies; creates CAPs and coordinates with regulators.

Skills

Quality improvement

Compliance management

HIPAA training

CMS liaison

Regulatory reporting

Data analysis

Education

Bachelor's degree

Master's degree

Tools

HPMS

CMS reporting systems

Job description

SAN-Ysidro-Health is seeking a Director of Quality and Compliance for the San Diego PACE program. You will lead the quality improvement and compliance activities, overseeing data management, reporting, and staff training to ensure alignment with CMS, HIPAA, and state/federal regulations.

You will supervise the QI and Compliance teams, work with the Medical Director and IDT, and drive performance improvements through analysis and policy development within a collaborative, regulated environment.