QI & Compliance Analyst

Gary and Mary West PACE; Seattle (WA); Remote; USD 60,000 - 75,000; Full time

Job summary

Join a rapidly growing all-inclusive day center for the elderly as a Quality Improvement and Compliance Analyst. This full-time remote position offers generous pay, benefits, and a supportive team culture. You will ensure compliance with regulations and enhance the quality of care for seniors.

Benefits

10 paid holidays

16 days of PTO

5% employer-match to 403b

Annual education allowance

Qualifications

• Bachelor's degree or 5 years experience in PACE.
• Experience with data management and analyses.

Responsibilities

• Conduct medical records audits and ensure compliance.
• Assist with state and federal audits.
• Track and trend Service Delivery Requests.

Skills

Analytical Skills

Communication

Organizational Skills

Leadership

Data Management

Education

Bachelor's degree in related field

5 years experience in PACE

Tools

MS Office Suite

Electronic Medical Records

Job description

Local candidates will be considered for this position.

Come work for Gary and Mary West Pace.

We are a rapidly growing all-inclusive day center for the fragile elderly.

This is a full time remote Monday through Friday day position. We are located in San Marcos, CA.

We offer several benefit plans to choose from and we also have a great 403B program

Why Work for Gary and Mary West PACE?

Because you desire work / life balance and have a passion to make a difference in the lives of North County seniors and their families!

You will receive generous pay and a benefits program focused on your health and wellness that includes 10 paid holidays, 16 days of PTO, a 5% employer-match to our 403b retirement program, and no on-call time.

Because we encourage professional development and support all staff to expand their skillset, providing an annual education allowance.

You will be part of a distinct company culture where work feels like family and collaborate with a multi-disciplinary team environment where you are appreciated and valued.

Come do your best work where your contribution matters!

About PACE

Philanthropists Gary and Mary West founded West Health with the mission of enabling seniors to successfully age in place with access to high-quality, affordable health and support services that preserve and protect their dignity, quality of life, and independence. The Gary and Mary West PACE (Program of All-inclusive Care for the Elderly), affiliated with West Health (www.westhealth.org), is a new non-profit that delivers medical, social, and behavioral services to the frail elderly to the North County of San Diego. This PACE center will be entrepreneurial in nature and will focus on innovations and bringing new processes to the traditional PACE environment.

We're looking for passionate healthcare providers who want to be part of a team dedicated to enable seniors to live in their communities as independently as possible by providing compassionate, comprehensive health and supportive care.

Position Summary :

Under the direct supervision of the Quality Improvement & Compliance Director and in close collaboration with the Medical Director, the Quality Improvement and Compliance Analyst is responsible for the maintenance and implementation of the Gary and Mary West PACE (GMWP) Quality Improvement program. In addition, the Quality Improvement and Compliance Analyst monitors staff compliance with state and federal regulations and GMWP policies and procedures and partners with the leadership team to promptly resolve any compliance issues. The Quality Improvement and Compliance Analyst facilitates collaborative relationships across GMWP teams and stakeholders to promote the GMWP values, team culture and mission.

Essential Functions :

• Conduct medical records audits as assigned. Monitor participant medical records for complete and timely documentation.
• Responsible for maintaining regulatory compliance of all medical records within HIPAA standards.
• Ensure that participant medical record is retained for a minimum required period as outlined in GMWP policies and procedures.
• Participate in ongoing EMR trainings and subsequent learning opportunities on system enhancement / upgrades and related workflows.
• Assist in the development of training materials, training content, and topics for on-going EMR training based on chart review and input from leadership and users.
• Track and trend Service Delivery Requests, assuring that all regulatory timelines are met.
• Track and trend Grievances and Appeals, assuring that regulatory timelines are met.
• Assist the staff prepare for and successfully complete state and federal audits.
• Assist with PACE audits by preparing documents for desk reviews submission and, while auditors are on-site, assist the regulators navigate the EMR to access required information.
• Assist with audit plans and perform internal and external audits of workforce and provider compliance with federal and state regulations and all applicable contractual obligations.
• Facilitate the gathering and validation of data required to complete the annual HOS- M survey, with the goal of maximizing participation.
• Complete all required documentation in a timely and accurate manner.
• Protect privacy and maintain confidentiality of all company procedures and information about employees, participants and families.
• Follow GMWP policies and procedures and participate in any required Quality Improvement activities, staff training and meetings.
• Assist to collect QI department data including that specified in the QI plan and required by state and federal regulations.
• Other duties as assigned.

Education and Certification :

Bachelor's degree in related field or 5 years of experience working in Program of All-Inclusive Care for the Elderly (PACE).

Skills & Experience :

• Experience with managing data and conducting analyses in productivity suite software including complex spreadsheets and preferably relational and / or hierarchical databases.
• Experience working in an Electronic Medical Records strongly preferred.
• Possess knowledge of HIPAA Privacy and Security.
• Possess knowledge of state and federal PACE regulations and contractual requirements.
• The ability to meet deadlines and manage tasks accordingly.
• Must possess strong analytical and organizational skills, as well as professional verbal and written communication skills.
• Ability to work independently with minimal supervision and ability to multi-task.
• Competence in use of computers for business analysis and communication.
• Ability to exercise strict confidentiality with all aspects of the position.
• Demonstrated ability to work and communicate effectively with employees at all levels.
• Proficiency with MS Office Suite, Word, Outlook, PowerPoint & Excel.
• Minimum of 1 year of experience with frail elderly population preferred.
• Ability to process accurate information in a timely manner.
• Excellent leadership, organizational, customer service and communication skills with seniors, their families and interdisciplinary team members.
• Highly motivated, self-directed, able to execute tasks in a quickly changing environment and make sound decisions in emergency situations.
• Experience and competency working with people from diverse backgrounds.
• Commitment to unlocking the full potential of our most vulnerable seniors.

Medical Clearance :

Employee's must have medical clearance for communicable diseases and up-to-date immunizations before having direct participant contact.

Gary and Mary West PACE provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, pregnancy, military and veteran status, age, physical and mental disability, genetic characteristics, gender, gender identity, gender expression or sexual orientation or any other considerations made unlawful by applicable state or local laws.