QUALITY AND COMPLIANCE MANAGER 

Ready to join a growing company whose work profoundly impacts people’s lives in their community, who offers an excellent learning environment, opportunities to advance and the ability to work alongside talented business leaders/professionals? CareStar, Inc. is currently seeking a Quality Improvement Manager. The Quality and Compliance Manager will lead the agency’s quality improvement and compliance activities, including participation in the development, revision and execution of CareStar’s Quality Management and Improvement Plan. The QI Manager will oversee the development and refinement of systems for the collection of the data needed to assess CareStar’s progress in achieving quality improvement goals as needed for reporting on performance.

THE POSITION

CareStar is looking for a motivated individual who:

• Adheres to the CareStar Rule in performance of job responsibilities.
• Understands and complies with CareStar Policies and Procedures.
• Maintains confidentiality as related to patient information. Any disclosures of confidential information made unlawfully outside the proper course of duty will be treated as a serious disciplinary offense.
• Follows the Acceptable Use Policy while using any information systems owned or controlled by CareStar, Inc.
• Oversees compliance and oversight of Health Insurance Portability and Accountability Act (HIPAA) regulations; develops and directs quality assurance and risk management activities through CareStar’s operations.
• Serves as the organization’s Data Protection Officer and maintains responsibility for the privacy of covered information, which includes being the Point of Contact for security incidents.
• Hires, supervises, directs, counsels, evaluates, and disciplines members of the Quality Improvement Department, as necessary.
• Responsible for the successful implementation of quality management and improvement plans.
• Develops, implements, revises, and maintains, as needed, systems for the collection, analysis, evaluation, and reporting of performance and consumer outcome data.
• Directs the development and implementation of quality improvement processes and tools, such as chart audits, consumer satisfaction surveys, focused audits and QI reviews. Ensures comprehensive and accurate reporting and recommendations.
• Guides and oversees preparation for contract or program reviews related to compliance, performance, and quality improvement.
• Oversees monitoring of compliance and collection of evidence of same for plans of correction.
• Prepares and ensures CareStar’s performance and management reports are accurate, complete, and submitted within contractual time frames.
• Identifies any obstacles to timely report preparation and/or of high-risk situations and creates a plan to mitigate obstacles or risks.
• Reviews quality monitoring findings to evaluate CareStar’s progress towards the achievement of goals identified in quality management and improvement plans.
• Chairs QI and Compliance Committee/Team meetings; prepares reports and tracking of quality measures for QI and Compliance Committee review and response.
• Oversees the complaint resolution process, maintains adherence to specified processes and time frames.
• Reviews and dispositions all requests for records production from Individuals and external agencies.
• Makes recommendations to CareStar executive management for policy/procedural changes and assists with development of policies and procedures, as requested.
• Identifies topics for team development and participates in the planning and delivery of team education/training programs, as appropriate.
• Participates in sales presentations, RFPs, RFIs and other proposals.

QUALIFICATIONS AND EDUCATION REQUIREMENTS

• Bachelor’s Degree in a business or health-related field; current, active license as a Licensed Social Worker, Licensed Independent Social Worker, or Registered Nurse preferred.
• Minimum of sixty (60) months’ program management or program analysis experience, preferably in a health or social work setting.
• Possesses Certification in Healthcare Quality (CPHQ) preferred.
• Experience in a healthcare setting or health-related practice.
• Knowledge of and experience in the application of quality improvement principles and methods.
• Excellent organizational skills with ability to prioritize projects and be attentive to detail.
• Computer skills sufficient to entering and processing consumer information, data analysis, report preparation, and use CareStar’s website and email, such as, familiarity with suite of Microsoft Office programs.
• Valid driver’s license and car insurance as required by State law.

CareStar was founded in 1988 in Cincinnati, Ohio with the mission to Improve Communities by Improving Lives. We continue to be an industry leader in the field of Long-Term Care Case Management, Assessment, Population Health Management and Innovative Software Development Solutions.

WHY YOU SHOULD APPLY

• Competitive salary based upon experience, education and knowledge.
• Comprehensive benefits package with medical, dental, vision, and life-insurance.
• Company ownership through the well-established Employee Stock Ownership Program (ESOP).
• 401(k) with a generous Safe Harbor company matching contribution.
• Paid vacations and 10 holidays per year.

Come be part of a team that values and challenges you! If these responsibilities, qualifications and benefits catch your interest, apply today at CareStar’s Career page at www.carestar.com/careers.