What are the responsibilities and job description for the Director of Quality Management position at EveryAge?
Job Description
Job Description
Reporting to the Chief Quality and Compliance Officer, the Director of Quality Management provides guidance on clinical regulatory policy and auditing. This role ensures that all development requests from government or contracted oversight agencies are submitted timely, accurately, and in compliance with federal and state regulations. The Director also conducts compliance audits at EveryAge affiliate locations according to the compliance work plan.
Key Responsibilities
- Ensure compliance by examining records, reports, and documentation; recommend improvements to internal controls.
- Monitor benchmarks and indicators (e.g., PEPPER reports) to identify billing risks and recommend improvements.
- Audit clinical and claims submissions to ensure accurate billing for acuity-based payment services.
- Monitor Value Based Purchasing reports and assist locations in developing improvement strategies; prepare quarterly summaries.
- Maintain policies and procedures in line with regulatory changes, as directed by the Chief Quality and Compliance Officer.
- Address compliance, policy, and regulatory questions; assist with problem-solving.
- Identify, investigate, and report compliance issues and violations.
- Support facilities during surveys and audits by accreditation organizations, Medicare, Medicaid, and third-party payors.
- Stay informed of regulatory changes affecting service delivery and reimbursement; maintain knowledge of relevant rules and regulations.
- Communicate with government agencies on behalf of the organization.
- Develop and provide employee training on quality and compliance policies and reporting systems.
Qualifications
What We Offer
