Quality Improvement Specialist

Company: WelBeHealth
Location: Modesto
Posted on: May 13, 2022

Job Description:

At WelbeHealth, we make the impossible, possible for underserved seniors. We do this through utilizing and developing cutting-edge healthcare and well-being service products especially for seniors and their families. Now is your chance to join our talented team that delivers unparalleled creative healthcare, insurance, social support and more to seniors. We create senior well-being through our courage to love, pioneering spirit and shared intention. These values permeate everything we do. At WelbeHealth, you'll help inspire that magic by enabling our teams to push the limits of healthcare and well-being experiences and create the never-before-seen! Under the direct supervision of the Executive Director and in close collaboration with the Medical Director, the - Quality Improvement Specialist tis responsible for the maintenance and implementation of the WelbeHealth Quality Improvement program; monitors staff compliance with state and federal regulations and - policies, procedures, coordinates, and coordinates WelbeHealth audits. The Quality Improvement and Compliance Specialist serves as the WelbeHealth Compliance Officer and HIPAA Privacy Officer and, will raise any compliance concerns to leadership, partnering with the team to support prompt resolution. In addition, the Quality Improvement and Compliance Specialist will implement the first QI and compliance program for WelbeHealth. The Quality Improvement Specialist is a member of the - leadership team and facilitates collaborative relationships across WelbeHealth teams and stakeholders to promote the WelbeHealth values, team culture and mission. Join us and enjoy: Monday-Friday 8AM-4:30PM (no wknds no overtime)
Employment Opportunity
Competitive Compensation Package -
Fully Benefited Opportunity including M/D/V
Competitive Retirement Package + Match
Quarterly Bonus - - What you'll do:

• In partnership with senior leadership, implement the QI and compliance program for the first WelbeHealth PACE program.
• Train and mentor QI and compliance staff at other WelbeHealth Clinics.
• Collaborate with the Medical Director on the development of QI Program initiatives.
• Responsible for the implementation of all the activities in the QI Program.
• Collect, analyze, and generate reports for all QI department data including that specified in the QI plan and required by state and federal regulations.
• Complete timely submission of all information required by regulatory agencies included but not limited to HPMS quality reporting and corrective action plans.
• Lead the staff through the preparation for and successful completion of all state and federal audits.
• Manage the preparation, implementation and follow up of all QI Program Committees, including but not limited to the Professional Medical Advisory Committee, Quality Improvement Committee, Participant Advisory Committee and Ethics Committee.
• Prepare the annual QI program outcome report for presentation to the Board of Directors, staff, participants and vendors.
• Coordinate the annual participant satisfaction and HOS surveys with the goal of supporting participation.
• Prepare and distribute quality analytics reports from the EMR regularly.
• Responsible for managing relationships with state and federal regulatory agencies, including the Centers for Medicare and Medicaid Services and Medicaid Fraud Control Units.
• Monitor staff (Team Member and contractor) compliance with WelbeHealth policies and procedures.
• Partner with the leadership team to develop and implement in-services of the PACE policies and procedures and resolve compliance issues as they arise.
• Coordinate with WelbeHealth to develop and distribute written compliance policies and procedures to all appropriate individuals and proposing changes to the policies as necessary.
• Coordinate the WelbeHealth compliance program including but not limited to educating staff and other stakeholders on the compliance program standards, monitor adherence to the compliance program and research complaints or reports of actual and suspected misconduct of non-compliance.
• As the HIPAA Privacy Officer oversee the implementation of, and adherence to WelbeHealth's HIPAA Privacy policies and procedures, coordinating privacy risk assessments; reporting directly to the WelbeHealth Board of Directors or delegated sub committee regarding HIPAA compliance; overseeing HIPAA training for workforce members; monitoring of Business Associate Agreements; and managing investigations and reporting for security incidents and breaches if necessary.
• Provide regular reports on the compliance position to the Board of Directors or delegated subcommittee.
• Complete all required documentation in a timely and accurate manner.
• Protect privacy and maintain confidentiality of all company procedures and information about team members, participants, and families.
• Follow WelbeHealth policies and procedures and participate in any required Quality Improvement activities, staff training and meetings.
• Other duties as assigned. - Why you'll love working at WelbeHealth:
  • As an employee of our program, you will have the ability to help shape our processes and have ample opportunity for growth.
  • You'll have the opportunity to develop creative solutions for participants and to practice "person-centered care," empowering and helping our participants meet their goals. - Your qualifications:
    • Bachelor's Degree in relevant field.
    • Master's Degree in relevant field preferred.
    • Minimum of three years' experience as a quality improvement/ assurance manager in a healthcare setting or managing health or eldercare programs with oversight of compliance.
    • Experience in or knowledge of health care compliance, including PACE-specific program compliance, and HIPAA requirements, strongly preferred.
    • Experience with managing data and conducting analyses using productivity suite software including complex spreadsheets and preferably relational and/or hierarchical databases.
    • Experience working in an Electronic Medical Record strongly preferred.
    • Highly motivated, self-directed, able to execute tasks in a quickly changing environment and make sound decisions in emergency situations.
    • Excellent organizational and communication skills.
    • Ability to work independently with minimal supervision. ---Demonstrated ability to prioritize in a fast-paced environment.
    • Experience and competency working with people from diverse backgrounds and cultures.
    • ---Bilingual English/Spanish preferred
    • Commitment to unlocking the full potential of our most vulnerable seniors. COVID-19 Vaccination Policy At WelbeHealth, our mission is to unlock the full potential of our vulnerable seniors. In this spirit, please note that we have a vaccination policy for all of our employees and proof of vaccination prior to employment is required. Our Commitment to Diversity, Equity and Inclusion At WelbeHealth, we embrace and cherish the diversity of our team members, and we're committed to building a culture of inclusion and belonging. We're proud to be an equal opportunity employer. People seeking employment at WelbeHealth are considered without regard to race, color, religion, sex, gender, gender identity, gender expression, sexual orientation, marital or veteran status, age, national origin, ancestry, citizenship, physical or mental disability, medical condition, genetic information or characteristics (or those of a family member), pregnancy or other status protected by applicable law.

Keywords: WelBeHealth, Modesto , Quality Improvement Specialist, Other , Modesto, California