What are the responsibilities and job description for the Compliance, Quality and Risk Manager - Hybrid position at Community Health Programs, Inc.?
ABOUT THE ORGANIZATION
Community Health Programs is a network of health centers and caring professionals that provide outstanding primary and preventive care for patients of all ages. What's truly unique to CHP is our broad spectrum of support services that extend beyond medical and dental issues to strengthen families and improve children's well-being. The region is a federally designated rural community and a Medically Underserved Population Area.
Community Health Programs embraces its role as a nonprofit health care provider and community partner. We are a leader in the communities we serve by providing high quality healthcare, dental services, wellness education and family support services. CHP outreach provides free health screenings, insurance enrollment assistance as well as information so people can learn how to take better care of themselves and their families.
Salary Range: $105,000 - $121,500 / year This role offers a hybrid work arrangement, with two days per week required on-site. Reporting to the Chief Operating Officer, the Compliance, Quality and Risk (CQR) Manager is responsible for implementing compliance and quality processes across sites and supporting organizational adherence to regulatory requirements. This role ensures adherence to federal, state, and local regulatory requirements, maintains organizational policies and procedures consistent with FQHC standards, and promotes a culture of ethical conduct, patient safety, and continuous improvement. The CQR Manager works collaboratively with leadership, clinical teams, and operational departments to coordinate quality improvement activities and assist with mitigation under established policies. This person will support CHP's mission, vision, and values and will adhere to compliance protocols as well as CHP's policies and procedures.
POSITION REQUIREMENTS
Essential Duties and Responsibilities
- Implement and monitor the organization’s Compliance Program in alignment with HRSA, CMS, OIG, HIPAA, ACO and UDS requirements under established program guidelines and COO direction.
- Maintain current knowledge of regulatory requirements and assist with updating policies as directed by leadership.
- Conduct medical record audits following established processes as prioritized by the annual work plan, quality related initiatives, or payer requests.
- Manage the anonymous reporting hotline and perform investigations, ensuring timely documentation and follow-up, under the oversight of the COO.
- Support corrective action plans and escalate findings to leadership for review and approval.
- Coordinates QA/PI activities including patient experience surveys and reviews, clinical quality measure satisfaction (UDS measures, HEDIS measures, Annual Wellness Visits), pursuant to HRSA and PCMH requirements, value-based care agreements, pay for performance and other population health initiatives.
- Analyzes and audits quality data to present to leadership to determine action plans to enhance organizational performance in relation to quality measures and value-based/pay-for-performance initiatives.
- Provides education to departments on quality standards and initiatives.
- Supports risk management activities by tracking incidents and assisting with mitigation steps under established plans.
- Monitor incident reports, patient safety events, and trends to reduce organizational risk.
- Collaborate with clinical leadership to enhance patient safety and quality improvement initiatives.
- Coordinates documentation and assists with readiness activities for audits and surveys as directed by leadership.
- Monitor changes in federal and state regulations and communicate impacts to leadership.
Education and Training:
- Associates degree, Bachelors preferred in business, healthcare, or related field.
- LPN or RN
- Knowledge of FQHC programs and other grant funded programs.
Physical Requirements:
- Click here to view the Administrative ADA Requirements.
FULL-TIME/PART-TIME Full-Time
POSITION Compliance, Quality and Risk Manager
EXEMPT/NON-EXEMPT Exempt
LOCATION MA, Great Barrington, CHP Administrative Offices
EOE STATEMENT
We are an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status or any other characteristic protected by law.
Salary : $105,000 - $121,500