Director of Compliance, Quality & Risk- Home Care & Hospice

Quality And Risk Management Program Director

About Tufts Medicine Care at Home

Care at Home is the region's most trusted provider of home health and hospice care for infants, children and adults. Our care teams proudly serve 110 cities and towns in the Merrimack Valley, northeastern Massachusetts and southern New Hampshire.

Please Note: While primarily remote, this role may require onsite travel to Massachusetts on request, depending on business needs

Job Overview

This position has overall responsibility for the Quality and Risk Management program. Responsible for regulatory compliance including external reporting requirements for the Department of Public Health (DPH). Provide oversight of risk management and patient safety processes to minimize risk to the organization and provide a culture of safety and healing. In conjunction with the medical staff and system leadership, directs and coordinates Safety, Quality, and Performance Improvement initiatives. Collaborate closely with medical staff leadership to ensure physician competency and quality patient care.

Job Description

Minimum Qualifications:

• Bachelor's degree in Nursing, Physical Therapy, Occupational Therapy or related field.
• Current state license in clinical field.
• Five (5) years progressive leadership experience in Home Care system management overseeing Compliance, Quality, Patient Safety, or related area.

Preferred Qualifications:

• Master's degree in nursing, public health, health administration, or related field.
• Ten (10) years progressive leadership experience in Home Care/Hospice system management overseeing Compliance, Quality, Patient Safety, or related area.

Duties and Responsibilities: The duties and responsibilities listed below are intended to describe the general nature of work and are not intended to be an all-inclusive list. Other duties and responsibilities may be assigned.

• Initiates and oversees the development of a comprehensive Safety, Quality, and Performance Improvement program inclusive of the analysis and trending of data related to initiatives.
• Provides strategic oversight for patient safety and quality committees with accountability for distribution of organizational communication.
• Provides overall direction necessary to ensure clinical services are provided in accordance with standards established through state and federal regulations, including National Patient Safety Goals, and are evidence-based.
• Accesses organizational compliance related to clinical care in collaboration with entity leadership and staff.
• Identifies areas of vulnerability and directs the development of strategies to enhance compliance.
• In conjunction with medical staff and system leadership, directs and coordinates safety, quality, and performance improvement initiatives.
• In collaboration with clinical staff and leadership, participates in the monitoring, reporting and improvement activities related to clinical guidelines, healthcare quality and safety initiatives, accreditation, and regulatory requirements.
• Manage department staff in the performance of duties, setting standards, providing development and training, perform evaluations and set goals.
• Prepare standard reports for leadership and board use.
• Manage a team of coding clinicians, providing oversight of accuracy, performance metrics and consistent and timely submissions.
• Leads program and location through CMS survey- complete audit and documentation request
• Represent Care at Home on system wide quality initiatives

Physical Requirements:

• Must be able to sit, stand, walk, and talk most of the time; stoop, kneel, or crouch occasionally.
• Must be able to use hands to finger, grasp and feel.
• Ability to lift up to 10 pounds occasionally.
• Close, distance, color, peripheral, depth perception, and the ability to adjust focus.
• Must be able to clearly recognize alarms, understand and follow calls and instructions.

Skills & Abilities:

• Working knowledge of healthcare quality and patient safety management, data sets and databases, benchmarking, outcome measurement, team development. Knowledge of regulatory compliance, quality improvement science and analytics.
• Working knowledge of home care and hospice regulations, Oasis and Hope assessment tools and data sets, industry best practice and performance metrics, and ICD-10 coding protocols.
• Possess strong analytic skills, ability to interpret data; facility with using Excel.
• Sound critical thinking/decision-making skills and the ability to function well under pressure.
• Ability to cooperate in working with others to facilitate problem resolution with focus on process or system improvement.
• Excellent verbal, written and presentation communication skills and ability to build relationships.
• Highly developed organizational, interpersonal, and management skills.
• Proficiency with Microsoft office applications.
• Good leadership skills.
• Knowledge of credentialing and peer review.
• Ability to lead/facilitate change and motivate staff and physicians.

Job Profile Summary

This role focuses on ensuring the organization's business activities are conducted ethically and in compliance with relevant regulations, laws, and standards. In addition, this role focuses on performing the following Compliance duties: Defines and documents policies and procedures related to the standards established by the business that comply with applicable external legislation/regulations, but may also reflect a higher standard than the legally required minimum. Responsibilities also include employee compliance training, auditing compliance, investigating complaints, and verifying that deficiencies are corrected. A management role that supervises employees focusing on tactical, operational activities within a specified area, with the majority of time spent overseeing area of responsibility, planning, prioritizing and/or directing the responsibilities of employees. Goal achievement is typically accomplished through performance of direct and/or indirect reports. A role that directs a department or small unit that includes multiple teams led by managers and/or team Leaders. Responsibilities typically include ownership of short to mid-term (1-3 years) execution of functional strategy and the operational direction of the Department, problems faced are often complex and require extensive investigation and analysis, and requires ability to influence others to accept practices and approaches, and ability to communicate and influence executive leadership.

About Tufts Medicine

A healthcare system that works Tufts Medicine is more than a health system we're a community that empowers people to live their best lives by reimagining healthcare, advancing knowledge and pioneering discovery. Every team member plays an integral role in realizing our vision of creating the most equitable and frictionless healthcare experience in the world. Here, you'll join an enthusiastic community that champions your growth and receive generous benefits to support you and your family's well-being.

At Tufts Medicine, we want every individual to feel valued for the skills and experience they bring. Our compensation philosophy is designed to offer fair, competitive pay that attracts, retains, and motivates highly talented individuals, while rewarding the important work you do every day.

The base pay ranges reflect the minimum qualifications for the role. Individual offers are determined using a comprehensive approach that considers relevant experience, certifications, education, skills, and internal equity to ensure compensation is fair, consistent, and aligned with our business goals.

Pay Range :

$134,525.66 - $171,524.44