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Quality Director PACE

Company: Capital Health
Location: Bordentown
Posted on: January 27, 2023

Job Description:

Overview:Develops, implements, organizes, and monitors the Quality Assurance and Performance Improvement Plan (QAPI) for the PACE Organization (PO) and ensures overall CMS regulatory compliance. Oversees the developing and implementing the annual QAPI plan, including leading quality initiatives and projects alongside the Medical Director. Ensures that data is collected from appropriate sources, is examined, and results are shared with all stakeholders.Responsibilities:Demonstrates Capital Health values to all internal and external customers (participants, visitors, volunteers, and colleagues.) Creates and maintains an atmosphere of warmth while propagating a calm environment throughout the office. Executes assignments in a culture that is shared and collaborative across all divisions within Capital Health PACE.Reflects the skills knowledge and abilities serving in the role of a leader. Defines and shares a strategy and vision. Aligns resources toward achievement of organization results. Grows and sustains the organization. Identifies, leads, and embraces change. Establishes and maintains as a member of the leadership team a plan to achieve operating goals.Promotes and maintains collaborative relationships with managers, peers, direct reports, and customers by effectively fostering a team environment, building consensus and resolving conflicts.Maintains department budget, places orders for equipment and supplies as necessary. Identifies financial vulnerabilities and makes cost reduction recommendations as needed. Evaluates, develops, mentors, coaches, counsels, and disciplines department staff. Supports other personnel from other departments through coaching and mentoring to help achieve optimum standard of excellence. Addresses issues of concern through courageous conversation and notifies department manager of any interactions requiring attention.Maintains a working knowledge of applicable Federal, State, and local laws and regulations, as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical, and professional behavior.Assesses disaster recovery, crisis management, and business continuity plans and acts within role that is developed within the business continuity plan, including working at another location, remotely from home, and maintaining constant contact with key personnel. Attends and participates in scheduled training, in-service training, mandatory annual in-service training, and educational classes as required or needed.Initiates, develops, and guides the implementation of the annual Quality Assurance Performance Improvement plan (QAPI) alongside Medical Director. Compiles annual report and shares results with leadership, staff, contractors, administration, the Participant Advisory Committee (PAC), and Board of Directors. Communicates the QAPI plan to members, staff, contractors, administration, Participant Advisory Committee (PAC), and the Board of Directors.Assists with scheduling and coordination of the PACE Quality Management Committee in collaboration with Medical Director including preparation of meeting agenda, preparation of minutes, and assistance with committee correspondence and presentation materials. Assures annual review and approval of Infection Control plan.Ensures compliance with CMS regulations. Oversees the Medicare Part D fraud, waste, and abuse Compliance Program. Assures annual review and approval of Compliance plan. Ensures that colleagues complete the activities and responsibilities identified in the Compliance program and those related to the HIPAA privacy rule.Manages preparation for CMS sites visits, inspections, and all subsequent follow up activities. Analyzes risk management data and QAPI data in order to identify and control loss. Coordinates and maintains all activities pertaining to complaints, service delivery requests, and grievances and appeals, assures regulatory compliance and incident reporting including trend analysis for necessary action plans and quality improvement initiatives.Plans, develops, organizes, implements, evaluates, coordinates, and directs infection control program in accordance with current rules, regulations, and guidelines that govern such requirements. Prepares monthly summaries of all participantand personnel infections, corrective action taken, and the results of the corrective action. Leads and facilitates Participant Satisfaction and HOS survey process and analyzes data.Ensure accurate and timely reporting to CMS, State, and all other Capital Health PACE reporting requirements. Monitors HPMS complaints and memorandums for quality and compliance updates daily. Coordinates any necessary actions per HPMS memorandum guidance. Prepares and submits monthly quality metrics reporting to Capital Health PACE and participates in Capital Health PACE initiatives, meetings, and programs as required.Assists staff in establishing process evaluation, including root cause analyses and performance improvement initiatives. Provides oversight of Quality and Compliance staff, including developing annual performance reviews, if applicable. Maintains confidentiality of participant information.Requirements:Bachelor's degree in a healthcare related field required. Degree in quality management preferred. BSN or Master's degree preferredNew Jersey RN license.Five years of experience that includes the development and implementation of progressive programs for the elderly population, service operations, and staff development. One year of documented experience working with a frail or elderly population. Prior supervisory experience preferred.Posseses business acumen, manages conflict well, is customer focused, and has high decision quality. Has flexibility to adapt to ongoing change and have organizational agility. Ability to work with minimal supervision and exercise independent judgment. Demonstrates superior written and verbal communication and presentation skills appropriate for audience comprehension. Has well-developed communication skills, both written and oral, that may be used either in an on-site or virtual environment is required. Communicates effectively with individuals and groups representing diverse perspectives. Ability to research, analyze and assimilate information from various on-site or virtual sources based on technical and experience based knowledge. Must exhibit critical thinking skills and possess the ability to prioritize workload. Excellent organizational skills. Ability to perform multiple duties and functions related to daily operations and maintain excellent customer service skills. Ability to perform frequent detailed tasks and provide immediate service with frequent interruptions. Ability to change and be flexible with work priorities. Strong problem solving skills.Comprehensive to expert proficiency with Microsoft product suite (MS Word, Excel, Power Point, etc.); basic knowledge and experience with electronic mail and calendaring system. Knowledge of systems necessary, experience preferred. Ability to type with speed and accuracy. Ability to use other software as required to perform the essential functions of the job.Our Network:IND123

Keywords: Capital Health, Trenton , Quality Director PACE, Executive , Bordentown, New Jersey

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