What are the responsibilities and job description for the Director of Quality, Risk Management, and Compliance position at Upstate Family Health Center Incorporated?
The Director of Quality, Risk Management, and Compliance is responsible for overseeing and directing all activities related to quality improvement, risk management, and regulatory compliance within the Federally Qualified Health Center (FQHC). This role ensures that the organization maintains high standards of care and operates in compliance with federal, state, and local regulations. The Director will develop and implement strategies to enhance patient care quality, minimize risks, and ensure adherence to applicable laws and guidelines.
The Director Quality, Risk Management and Compliance reports to the Chief Medical Officer.
Qualifications: Master's degree or higher in a field related to leadership or a specific clinical specialty. Should be able to show certification in their Provider discipline. No less than 3 years of experience in a leadership position in healthcare, preferably an FQHC. The ideal candidate will also possess interpersonal skills which allow effective interaction with clients and multiple providers while maintaining a spirit of hope and empathy. Proficiency in Microsoft Office Suite, Electronic Health Records (EHR), and familiarity with regulations governing healthcare and practice scope is strongly preferred. Other skills and experience include but are not limited to:
Experience in dealing with a diverse and dynamic workforce
Experience in partnering with Executive Leadership and Board of Directors resulting in the development and implementation of operational strategies.
Experience working in Quality Assurance, Risk Management and Compliance is required.
Previous supervisory/managerial experience is preferred.
Experience working with a non-profit community health center is preferred.
Experience working with clinical informatics databases containing Protected Health Information.
Responsibilities include:
Quality Improvement
Develop, implement, and manage the organization's Quality Improvement (QI) program to enhance patient care and operational efficiency.
Monitor and evaluate clinical performance indicators and patient outcomes.
Facilitate and lead QI initiatives, including setting goals, developing action plans, and tracking progress.
Conduct regular audits and assessments to ensure compliance with internal policies and external regulations.
Working knowledge of a comprehensive health quality program (e.g. patient safety, peer review, and infection control)
Ensure accomplishment of organization's mission through creating infrastructure that enhances clinical and quality outcomes
Ensures continuous improvement by evaluating and making recommendations considering market demands, regulatory standards and clinical practice
Work closely with CMO and key stakeholders to ensure all clinical and quality metrics are accomplished
Ensure that Quality Improvement Compliance standards are met for all major grants and funders (FQHC/HRSA, FTCA, DHH/HRSA (Ryan White), HHS, etc.)
Work closely with Grants Manager and assist in grant writing for new funding sources and competitive and non-competitive grant renewals for continued funding
In coordination with CMO, develop, implement and enforce clinical policies in accordance with funding requirements
Chair the Quality Management program of UFHC and attend at least one Quality Improvement conference per year.
Work with Clinical Leadership and Practice Management to create custom reports needed for ongoing maintenance of quality care and operations.
Respond to Ad hoc internal data requests from Leadership
Oversee Clinical Applications to ensure quality and data accuracy and cohesive workflows (i.e. EHR, etc.)
Monitor clinical compliance of medical providers MD, NP, PA and RNs and share findings with Chief Medical Officer (CMO), Senior Director of Clinical Operations, and through regularly generated reporting. (Examples include note closure, proper billing, performance measure feedback)
Responsible for quality incentive programs, CCA, ACO, IPA
Risk Management
Identify potential risks and implement strategies to mitigate them, including the development of risk management policies and procedures.
Conduct risk assessments and develop action plans to address identified risks.
Oversee incident reporting and investigation processes to identify trends and prevent recurrence.
Provide training and support to staff on risk management practices and protocols.
Compliance Management
Serve as Program administrator for FQHC/HRSA, FTCA, DHH/HRSA (Ryan White), HHS funding grants
Ensure the organization complies with all federal, state, and local regulations, including those specific to FQHCs.
Develop and update compliance policies and procedures to reflect changes in regulations and best practices.
Conduct regular compliance audits and reviews to identify and address potential issues.
Serve as the primary point of contact for regulatory agencies and manage compliance-related correspondence and documentation.
Leadership and Team Management
Lead and mentor the Quality, Risk Management, and Compliance team to foster a culture of continuous improvement and accountability.
Collaborate with other departments to integrate quality, risk management, and compliance efforts into overall organizational operations.
Develop and deliver training programs to educate staff on quality improvement, risk management, and compliance matters.
Supervisory responsibilities are subject to change based on organizational needs and department growth.
Reporting and Communication
Prepare and present reports on quality, risk management, and compliance activities to senior management and the Board of Directors.
Communicate effectively with staff, patients, and stakeholders regarding quality, risk, and compliance issues.
Stay current with industry trends, best practices, and regulatory changes to ensure the organization remains up-to-date and compliant.
Administer and analyze annual Patient Satisfaction Survey
Coordinate quarterly Continuing Quality Management Committee and monthly Sub-committees
Coordinate and Manage Quality Improvement Projects
Present Monthly reports to the QPI Committee of the Board and Quarterly updates to the Board of Directors which include key Data Reports, progress reporting on Quality Improvement Projects, annual updates on UDS and Pt Satisfaction Survey, and other key Quality Improvement/Assurance activities.
Develop, update, and maintain Quality Improvement/Assurance and Clinical Application Policies and Procedures and present to the Board of Directors for review and approval as needed.
In coordination with CMO design and administer biannual peer-to-peer chart reviews
Coordinate with Risk Management to design and implement Quality Improvement Projects in response to risk events
Ensure timely submission of monthly and quarterly data progress reports required by funders
Work with Clinical Leadership and Practice Management to great custom reports needed for ongoing maintenance of quality care and operations.
Respond to Ad hoc internal data requests from Leadership
Oversee Clinical Applications to ensure quality and data accuracy and cohesive workflows (i.e. EHR, etc.)
Monitor clinical compliance of medical providers MD, NP, PA and RNs and share findings with Chief Medical Officer (CMO), Senior Director of Clinical Operations, and through regularly generated reporting. (Examples include note closure, proper billing, performance measure feedback)
Other duties as assigned
Work environment: Generally, works in a clinical office environment but may occasionally be required to perform job duties outside of the typical clinical setting. Availability for occasional work outside of regular office hours.
Travel requirements: Occasional local travel required between main clinic and SBHCs.
Work hours: 40 Hours/Week (M-F 8:00am - 4:30pm)
Required Screenings: Must complete UFHC Credentialing and Privileging to provide direct services with Federally Qualified Health Centers.
Upstate Family Health Center is an Equal Opportunity Employer.
About Upstate Family Health Center Incorporated
Upstate Family Health Care Inc. is a Federally Qualified Health Center (FQHC) offering family health care services to individuals of all ages at various locations throughout Mohawk Valley. We are committed to providing high-quality, patient-centered care. Our mission is to serve the diverse needs of our community with compassion and dedication. By joining our team, you will be part of a collaborative environment that values innovation and excellence in healthcare delivery. Utica, NY, centrally located in New York State, offers a unique blend of cultural richness and natural beauty. The Mohawk Valley is known for its picturesque landscapes, historic landmarks, and a welcoming community. Enjoy outdoor activities such as hiking, skiing, and boating, as well as vibrant arts and culinary scenes. The area is ideal for those seeking a balanced lifestyle with a variety of recreational opportunities.
