- Quality & Compliance Senior Manager
- Cenikor Foundation in Houston, Texas, United States
- jobs
- 2 weeks ago
jobs description
Quality & Compliance Senior Manager - Houston, TX
Cenikor‘s Value Proposition - What‘s In It for You?
PURPOSE
in your work - service to others, giving back to your community, helping to save lives, being fulfilled how we served last year. COMPETITIVE PAY, BENEFITS, PAID TIME OFF, TUITION REIMBURSEMENT, up to 10% 401K
and
BONUSES
- we hire and reward high performers.
1.Benefits for full-time team members include Medical, Dental, Vision, Basic Life & AD&D, LTD, STD, Accident, Critical Illness, HRA/FSA
STABILITY
and
GROWTH
- more than 55 years in business - our strong financial processes support our drive to serve more people and ensure stability for our team members. CONTINUOUS LEARNING
and
PROFESSIONAL DEVELOPMENT
- we are committed to developing our leaders in their desired career path and promoting from within. We have Cenikor Career Pathways Program that you can join after 90 days of employment. We also have an annual leadership development program with assigned mentors to help you achieve your professional goals. More than 25% of our total employees have been promoted the last 4 years.
STUDENT LOAN FORGIVENESS
- The Public Service Loan Forgiveness (PSLF) forgives your qualified student loans if working for a non-profit for a specific period of time. Find out more here. The work we do isn‘t easy. If you like purposeful hard work, serving others and having FUN with your team while achieving goals, Cenikor will be the right place for you!
SCHEDULE:
8am-5pm
ESENTIAL FUNCTIONS:
Maintain and track clinical compliance records ensuring all documentation is correct and submitted in a timely manner. Ensure Milliman standards are met for clinical documentation. Work closely with leadership, QI, training and HR to identify root cause needs and develop solutions for improved clinical and contract performance. Conduct monthly QI and regular compliance audits and risk assessments to identify gaps in clinical quality and address any compliance gaps.
Conduct New Hire Audits for new clinicians at 30, 60 and 90 days.
Develop and maintain clinical standards in conjunction with QI, Clinical Managers and UR departments, ensure consistent documentation. Train clinicians on the appropriate documentation areas to increase clinical quality and time frames. Monitor and evaluate training program‘s effectiveness, success and ROI at regular intervals and report to leadership council. Coordinate with regulatory agencies and manage communication regarding compliance issues or inspections. Monitor and analyze quality metrics and trends to drive continuous improvement initiatives.
Develop and deliver training programs on compliance and quality management topics to employees at all levels. Ensure staff are aware of compliance and quality requirements and understand their roles in maintaining these standards. Act as the primary point of contact for compliance and quality-related inquiries from internal and external stakeholders. Collaborate with cross-functional teams to address compliance and quality issues and implement solutions.
Maintain a keen understanding of clinical trends, developments and best practices. Conduct spot audits for compliance in EHR systems and identify training opportunities and gaps based on audit results and data analysis. Ensure completion of Big 5 performance management tool by the required deadline and use of SMART goals to support annual performance compensation review. Uphold the core principles of Cenikor‘s culture and create a positive working environment for all team members.
Perform additional duties as assigned and consistent with the exempt functions as assigned in this job description.
QUALIFICATIONS FOR THE POSITION:
Skills, Knowledge, and Abilities:
Knowledgeable about substance abuse treatment, prevention, and aftercare. Knowledgeable of insurance, Medicaid, and state funding admissions criteria, level of required documentation and timing. Proficient skills in the use of EHR software. Knowledgeable of quality compliance. Possess good time management skills needed to meet aggressive deadlines and prioritize multiple tasks. Presents a professional, positive image. Experience working with various types of…