Quality & Compliance Specialist

St Pauls Senior Services•SAN DIEGO, CA

1d•Onsite

About The Position

This is a Temporary Full-time position with an anticipated duration of 4 months, with the possibility of extension. The typical schedule for the position is Monday - Friday, 8:00AM - 4:30PM. Under the direction of the Quality and Compliance Manger, the Quality and Compliance Specialist is responsible for ensuring that the healthcare organization meets all regulatory and accreditation standards. This role involves developing, implementing, auditing and monitoring quality improvement initiatives, as well as ensuring compliance with local, state, and federal regulations. The specialist will work closely with clinical and administrative staff to promote a culture of safety, quality, and compliance. Quality and Compliance specialists play a vital role in assisting with the implementation of the Quality Assessment and Performance Improvement Plan (QAPI) for the St. Paul’s PACE program.

Requirements

Bachelor’s degree in Healthcare Administration, Nursing, or a related field.
Must have a minimum of one year’s experience working with the frail or elderly.
Proven experience in healthcare auditing or quality assurance/improvement.
One to three years or more years of relevant compliance experience and/or quality improvement is required; experience in health-care or aging services compliance highly desirable.
Strong knowledge of healthcare regulations and accreditation standards.
Excellent written and verbal communication, with specific ability to maintain accurate records.
Effective in project management/ LEAN Process Improvement
Ability to manage multiple projects and meet deadlines
Strong ability in auditing and monitoring
Effective data collection and analysis skills/knowledge of basic statistical principles
Excellent analytical and problem-solving skills
Strong communication and interpersonal skills
Maintains the confidentiality of all company procedures, results, and information about residents and participants, clients or families
Maintains courteous, helpful and professional behavior on the job

Nice To Haves

Certified Professional in Healthcare Quality (CPHQ) or Certified in Healthcare Compliance (CHC) is preferred.
Experience in a clinical setting is a plus.

Responsibilities

Assures full implementation of the annual QAPI Plan, performs contract facility quality assurance audits to ensure quality participant care, collaborate with clinical staff to develop and implement evidence-based practices
Lead quality improvement initiatives aimed at enhancing patient care and safety and analyze data to identify trends and areas for improvement, and recommend corrective actions.
Conduct regular audits and assessments to ensure compliance with healthcare regulations, including HIPAA, OSHA, CMS, and specific state regulations.
Develop and implement policies and procedures to address compliance issues, with a focus on adherence to state-specific healthcare regulations.
Monitor and ensure compliance with state licensing requirements, including timely renewals and adherence to operational standards mandated by the state.
Conduct risk assessments to identify potential areas of non-compliance with state regulations and work with departments to develop mitigation strategies.
Provide training to staff on compliance and quality standards, including new regulations and best practices. Develop educational materials and conduct workshops or seminars to promote a culture of quality and compliance.
Ensures staff integration into the QAPI process through Continuous Quality Improvement education and developing opportunities for input.
Manage the grievance and incident reporting process, including investigating and documenting case details, and ensuring appropriate corrective actions are taken.
Maintain detailed records of compliance activities, audit results, and quality improvement initiatives.
Participates in quality assurance-related communication between contract facilities and St. Paul’s PACE Interdisciplinary Teams.
Other duties as assigned