University of Rochester Assoc Quality & Compliance Officer in Rochester, New York

Opening

Full Time 40 hours Grade 055 EIOH Finance & Admin

Schedule

8 AM-5 PM

Responsibilities

*Position Overview: *

This position is responsible for the business, financial and administrative management of the EIOH OQIC. Oversees and directs initiatives to support the mission of the OQIC for all EIOH divisions, including Eastman Dental site, Dentistry at Strong Memorial Hospital, Highland Hospital Dental, Community Dentistry Division sites, and the University Dental Faculty Practice Group.

This key leader will develop strategic direction, implement and monitor quality initiatives, design quality measurement systems, enhance and participate in patient/employee training programs and safety efforts, and oversee regulatory compliance across all programs, services and operations.

Specific Responsibilities:

This person will work with considerable latitude for exercise of independent judgment.

Provides strategic leadership with the capacity to guide, interpret, revise, and implement compliance matters, quality improvement, risk management, safety, HIPAA, accreditation, and infection control policies and operations, consistent with State of New York Official Compilation of Codes, Rules, and Regulations (10 NYCRR). Provides information for institutional planning to prevent, minimize, eliminate or rectify non-compliant situations.

Develops policies and procedures and utilizes communication skills that encourage managers and employees to report safety concerns, near-misses, suspected fraud, and other improprieties without fear of retaliation.

Develops plans and oversees the implementation of quality improvement efforts designed to improve clinical performance and maintain compliance with NYSDOH, JCAHO, HIPAA, and other accreditation standards.

Responsible for enforcing disciplinary guidelines through well-developed and communicated policies.

Serves as primary point of contact for federal, state, and governmental agency queries and audits including those conducted by appropriate subcontractors.

Oversees, directs, delivers, and/or ensures delivery of a multifaceted educational and training program that focuses on all elements of the compliance program, and seeks to ensure that all appropriate employees, students, residents, faculty and management are knowledgeable of and compliant with pertinent federal and state standards.

Establishes and administers a process for receiving, documenting, tracking, investigating, and taking action on all patient complaints. Works closely with EIOH Leadership, EIOH Privacy Officer, and the offices of URMC Patient and Family Relations, URMC Quality, URMC Compliance, URMC Chief Privacy Officer, and URMC Legal Counsel.

Responds to individual/departmental concerns, adverse events, patient harm, and near misses and conducts appropriate follow-up, i.e. records initial inquiries and assesses appropriate course of action, conducts investigative work to assess the situation, formulates proposed resolutions discusses with senior leadership corrective actions, and submits such incidences to New York Patient Occurrence Reporting and Tracking System (NYPORTS) when indicated . Facilitates the execution of the Root Cause Analysis (RCA) process.

Oversees, directs, delivers all information to the NYS Health Commerce System and Health Emergency Response Data System, including but not limited to patient transfers, RCAs, employee flu vaccination status.

Provides responses to certain requests for Medical Record and/or Subpoenas from the NY Department of Health Information, CMS, OIG, and any other information requests appropriately directed to OQIC.

Develops, compiles, analyzes and ensures the production of management reports containing review findings. Identifies areas requiring change. Develops and implements corrective action and is accountable for appropriate follow-up. Assists in formulating, reviewing and updating EIOH Compliance policies and annual EIOH Quality Plan, ensuring alignment with URMC compliance policies.

Performs internal reviews of clinical billing to determine compliance with billing policies and procedures annually and on an ad hoc basis. Conducts in-depth reviews of dental and medical record chart documentation to ensure compliance with HCFA guidelines. Ensures that chart documentation supports the designed billing level.

Maintains current knowledge of issues in the area of professional risk management, safety, quality and compliance issues through networking with peers/counterparts, review of literature and participation in seminars and update programs.

Requirements:

Bachelor’s Degree and 5 years of relevant experience or an equivalent combination of education, compliance and coding knowledge. Graduate degree and experience in nursing a plus.

EOE Minorities/Females/Protected Veterans/Disabled

Job Title: Assoc Quality & Compliance Officer

Location: Eastman Dental Center

Job ID: 203222

Regular/Temporary: Regular

Full/Part Time: Full-Time