Quality & Compliance Leader, PACE Programs

Appalachian Agency For Senior Citizens Inc; Cedar Bluff (VA); On-site; USD 60,000 - 64,000; Full time

Job summary

The Appalachian Agency For Senior Citizens Inc seeks a PACE Quality and Compliance Director to coordinate quality improvement activities and monitor care issues for PACE participants. The role drives action plans, ensures federal and state regulatory compliance, and communicates QA outcomes to staff for program excellence.

The director will coordinate QI programs, prepare annual reports for CMS/DMAS, and lead staff in compliance trainings, audits, and policy updates to maintain high-quality PACE

Qualifications

• Education equivalent to at least an Associate’s Degree form an accredited college with a degree in nursing, or related field or equivalent applicable education, experience, and/or training.
• Prior experience in applying quality assurance principles and participating in quality assurance programs.
• Demonstrated clinical experience in a variety of healthcare settings.
• Computer experience with proficiency in excel and PowerPoint.

Responsibilities

• Ensures staff and contracted personnel have knowledge of Quality Improvement and share data regarding QI activities with them.
• Develops and implements a strategic comprehensive quality assurance and risk management program based on key PACE program processes/services to facilitate an efficient and cost-effective, low risk healthcare organization.
• Produces data and reports on quality activities and performance and compliance.
• Ensures Board of Director Members are aware and have knowledge of current QI and Compliance activities; Presents QI Annual Report to the Board of Directors and conducts Compliance training with them.
• Assembles and analyzes data as information for CMS/NPA/DMAS reports as needed for the PACE Director.
• Monitors regulatory compliance and alerts PACE Director of possible deficits.
• Schedules and conducts quarterly compliance meetings and monthly quality meetings and maintains meeting minutes.
• Reviews and updates policies and procedures as needed.
• Conducts annual participant satisfaction surveys.
• Involves all staff in the QI program as owners of the program.
• Uses standard methodology to document and assess QI activities.
• Audits and/or maintains the Infection Control, Incident and Grievance Logs.
• Audits the service delivery requests log.
• Liaison with contracted vendor for the electronic medical record and trains and assists staff with usage.
• Assists staff in process review, critical indicator selection, and threshold levels.
• Involves PACE participants in the QI program.
• Develops systematic reporting to all components of the PACE program system.
• Performs chart audits to ensure completeness and accuracy.
• Compiles and submits data to CMS/DMAS/NPA as required or requested.
• Provides oversight of the PACE Emergency Safety Program and serves as PACE liaison to the Safety Committee.
• Liaison to Audit Teams from CMS and DMAS, preparing documents prior to audit, assisting during audit, and responding to Audit reviews and corrective action plans.

Skills

Quality Assurance principles

Objectives & planning

Problem solving

Critical thinking

Attention to detail

Effective communication

Presentation to groups

Data & word processing

Education

Associate’s Degree in nursing or related field

Bachelor’s degree in health-related field

Nursing program graduate

Tools

Excel

PowerPoint

Job description

The Appalachian Agency For Senior Citizens Inc seeks a PACE Quality and Compliance Director to coordinate quality improvement activities and monitor care issues for PACE participants. The role drives action plans, ensures federal and state regulatory compliance, and communicates QA outcomes to staff for program excellence.

The director will coordinate QI programs, prepare annual reports for CMS/DMAS, and lead staff in compliance trainings, audits, and policy updates to maintain high-quality PACE