DIRECTOR OF QUALITY - Compliance Officer

Custom Home Health Inc • Troy, MI

2d • Hybrid

About The Position

The Director of Quality/Compliance Officer will lead agency-wide compliance and quality initiatives for Home Health & Hospice. This role oversees the QA department, QAPI initiatives, and the Education/Training team, ensuring adherence to all Medicare regulations and accreditation standards. The position involves managing audits, surveys, data quality, policy development, compliance training, and collaborating with leadership on compliance strategy.

Requirements

• Certifications: OASIS (COS-C or HCS-O) and coding (HCS-D or HCS-H or CPC/CCS).
• Experience: 5+ years in home health/hospice clinical or coding roles, with 2+ years in QA/compliance leadership.
• Medicare Knowledge: Deep understanding of PDGM, HH PPS, Hospice Medicare rules, and documentation standards.
• Licensed RN.
• Management: Experience supervising teams (QA, education, coders). Strong policy development and analytical skills.

Nice To Haves

• Certifications: OASIS (COS-C or HCS-O) and coding (HCS-D or HCS-H or CPC/CCS).
• Compliance/Quality certifications (e.g. CHC, CHPC, CPHQ).
• Experience with HOPE implementation or Hospice Quality measures.
• Prior success leading multi-disciplinary committees.

Responsibilities

• Lead agency-wide compliance and quality: oversee QA department, Quality Assurance & Performance Improvement (QAPI) initiatives, and Education/Training team.
• Ensure adherence to all Medicare home health/hospice regulations (OASIS/PDGM, hospice benefit, QRP) and accreditation standards (e.g., ACHC, CHAP if relevant).
• Manage all audits and surveys: plan for and respond to RAC/UPIC requests, state surveys, and internal reviews.
• Oversee OASIS and HOPE/HIS data quality: review trends, error rates, and implement corrective action plans.
• Develop, update, and enforce policies and procedures (Medicare CoPs, documentation requirements, compliance plans).
• Conduct regular compliance training for clinicians (OASIS training, documentation accuracy, HIPAA).
• Oversee Staff Orientation and education program: ensure staff continuing education, certification renewals, competency evaluations, and ongoing professional development in compliance with organizational and regulatory requirements.
• Monitor Medicare denials and appeals: work with billing and clinical staff to correct systemic issues.
• Collaborate with clinical leadership and the governing board on compliance strategy, reporting key metrics.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager