At WelbeHealth, we make the impossible, possible for underserved seniors. We do this through utilizing and developing cutting-edge healthcare and well-being service products especially for seniors and their families. Now is your chance to join our talented team that delivers unparalleled creative healthcare, insurance, social support and more to seniors. We create senior well-being through our courage to love, pioneering spirit and shared intention. These values permeate everything we do. At WelbeHealth, you’ll help inspire that magic by enabling our teams to push the limits of healthcare and well-being experiences and create the never-before-seen!
Under the direct supervision of the WelbeHealth Quality Improvement Director and in close collaboration with the Medical Directors, the Regional Quality Improvement and Compliance (RQI&C) Manager is responsible for the maintenance and implementation of the Quality Improvement program; monitors staff compliance with state and federal regulations and WelbeHealth policies procedures and coordinates audits. Additionally, the RQI&C is responsible for ensuring the compliance and oversight of the medical records department. The Quality Improvement and Compliance Manager will raise any compliance concerns to leadership, partnering with the team to support prompt resolution. The Regional Quality Improvement and Compliance Manager is a member of the Northern or Southern California WelbeHealth PACE leadership team and facilitates collaborative relationships across WelbeHealth teams and stakeholders to promote our values, team culture and mission.
What you'll do:
- Hire, train, mentor and ensure high performance of quality team members and medicalrecord coordinators at each site.
- In partnership with senior leadership, implement and oversee the QI&C and compliance program including policies, procedures, QI&C plan and audits.
- Track and report on quality indicators by site
- Collaborate with the Medical Director on the development of QI&C Program initiatives.
- Responsible for the oversight of all the activities in the QI&C Program.
- Oversee monitoring and execution QI&C plan to ensure its being followed timely and appropriately.
- Oversee reports for all QI&C department data including that specified in the QI&C plan and required by state and federal regulations.
- In collaboration with data specialists, build and enhance reporting to support QI&C programming and improvement of processes and outcomes.
- Oversee timely completion and submission of all information required by regulatory agencies included but not limited to HPMS quality reporting and corrective action plans.
- Lead the staff through the preparation for and successful completion of all state and federal audits.
- Lead audits follow up needs including creation, implementation and tracking of corrective action plans.
- Oversee completion and tracking of internal corrective action plans.
- Oversee the preparation, implementation and follow up of all QI&C Program Committees, including but not limited to the Professional Medical Advisory Committee, Quality Improvement Committee, Participant Advisory Committee and Ethics Committee.
- In collaboration with Training department, train market teams on completing Root Cause Analysis, Impact Analysis, and Corrective Action Plans
- Ensure ongoing trainings are completed as required as related to QI&C program.
- Prepare the annual QI&C program outcome report in collaboration with Medical Director for presentation to the Board of Directors, staff, participants, and vendors.
- Master’s Degree in relevant field preferred; an additional three years’ of relevant QI&C
- Management experience may be substituted.
- Valid State Driver’s License with a clean DMV record.
- Copy of recent Vehicle Insurance required.
- Minimum of five years’ experience as a quality improvement/ assurance manager in ahealthcare setting or managing health or eldercare programs with oversight of compliance.
- Experience in or knowledge of health care compliance, including PACE-specific program compliance, and HIPAA requirements, strongly preferred.
- Experience with managing data and conducting analyses using productivity suite software including complex spreadsheets and preferably relational and/or hierarchical databases. (proficiency in excel analytics).
- Experience working in an Electronic Medical Record strongly preferred.
- Two years’ supervisory experience with demonstrated ability to mentor and develop team members.
- Deep commitment to helping unlock the potential of our most vulnerable seniors.
COVID-19 Vaccination Policy
At WelbeHealth, our mission is to unlock the full potential of our vulnerable seniors. In this spirit, please note that we have a vaccination policy for all of our employees and proof of vaccination prior to employment is required.
Our Commitment to Diversity, Equity and Inclusion
At WelbeHealth, we embrace and cherish the diversity of our team members, and we're committed to building a culture of inclusion and belonging. We're proud to be an equal opportunity employer. People seeking employment at WelbeHealth are considered without regard to race, color, religion, sex, gender, gender identity, gender expression, sexual orientation, marital or veteran status, age, national origin, ancestry, citizenship, physical or mental disability, medical condition, genetic information or characteristics (or those of a family member), pregnancy or other status protected by applicable law.