The Vice President of Quality and Compliance is a self starter who is responsible for advising the business as the subject matter expert on quality, legal, regulatory and licensure requirements to ensure ethical, compliant and high-quality operations and practices in a fast paced growth centered environment.  The scope of this role includes developing and implementing a strategic auditing and monitoring plan for evaluating the performance of the compliance and quality programs and related activities, to identify and mitigate risks and to initiate appropriate steps to improve program effectiveness.  This role has responsibility and oversight with direct communication with the Board of Directors and Executive Leadership where they will advise on both compliance and quality improvement planning and execution.  The specific areas of expertise and oversight for this role includes risk management, infection control, internal audit, quality improvement, licensing, regulatory compliance, and survey readiness.

As you join our mission to help those suffering from substance use disorders reclaim their lives, expect to thrive in a comfortable, welcoming, and fun environment where you are valued for the work you do, championed by passionate leaders, and equipped with the tools and ongoing training you need to achieve your goals. 

Along the way, we’ll invest in your well-being through a benefits package that includes:

• Subsidized medical, dental, and vision insurance
• Health savings account
• Short and long-term disability insurance
• Life insurance
• Paid sick, vacation, and holiday time
• 401K retirement plan with match
• Tuition and CME reimbursement up to 100%
• Employee assistance program to support your mental health and wellness
• Ongoing professional development 

Responsibilities:

• Responsible for strategic planning and operational leadership pertaining to quality, compliance and regulatory issues.
• Responsible for building, organizing, and supervising the activities of the quality and compliance department, including managing and leading department staff.
• Develops, maintains, implements and periodically assesses the quality and compliance program, ensuring that it is effective, properly structured and has sufficient resources.
• Leads cross-functional initiatives in accreditation readiness and facilitates the preparation and coordination of clinical record reviews by regulatory agencies.
• Provides direct, real-time support to Clinical and Medical Operations, Human Resources, Technology, Revenue-Cycle, and Growth Department procedures and initiatives while continuously working towards innovative solutions.
• Educates and assists department leaders and staff to maintain and follow appropriate policies, procedures, and documentation to fulfill requirements and regulations.
• Demonstrates current clinical knowledge as well as current knowledge of laws, regulations, and standards relating to CARF, State Health Departments, and Health Plans.
• Leads, creates and advises on the collection and tracking of quarterly internal audit data in partnership with Operations to drive patient outcomes.
• Directs and supervises quality staff and projects to meet unit goals for the quality program, including the monitoring of policies, procedures, activities in order to meet multiple contractual requirements, external accreditation, and state and federal regulations.
• In partnership with Operational and site base leadership, advises on improving operations based on data from performance indicators, delegation audits, and quality improvement processes.
• Serves as liaison with department managers to ensure that needs are met for internal and external reporting and analytics and the development of decision support tools.
• Facilitates the fulfillment of the Board of Directors’ compliance oversight responsibilities, including making annual reports to the Board of Directors
• Oversees internal and external audit procedures to meet customer requirements, accreditation standards and goals of the assigned business unit.
• Creates and executes an effective Quality Management/Performance Improvement program.
• Develops metrics to drive improvement of care and processes.
• Oversees and manages P&L to budget and makes stratgic ROI-oriented decitions.
• Develops, implements, and executes the risk management/patient safety plan with annual review and revision to meet organizational goals and regulatory compliance.
• Oversees corporate compliance program.
• Conducts annual compliance risk assessment and preparation of annual Compliance Work Plan.
• Oversees the Incident Reporting System to ensure event capture, tracking, analysis, and reporting occurs.
• Works with the CEO and Enterprise Legal to manage potential and actual litigation events.
• Serves as the organization's subject matter expert for risk management and patient safety; quality and compliance.
• Oversees Root Cause Analysis or other activities in response to events.
• Oversees management of the organization's Complaint and Grievance process.
• Develops, implements, and monitors accreditation readiness activities.
• Monitors new or revised regulations or standards that apply to the business and implement the necessary changes.
• Oversees organization's policy and procedure management process including development, revision and annual review of policies and procedures.
• Oversees the Infection Prevention Program.
• Informs the Executive Leadership Team and other appropriate leaders in a timely manner of significant compliance, risk management, quality and patient safety developments, including findings and actions taken as a result of monitoring and assessment, violations, and other risks/concerns, opportunities and challenges with the goal of educating and integrating into the strategic planning (DASH) process.

Education, Certification and Experience Requirements:

• Bachelor of Science Degree in a field such as Nursing or Social Work is required; Master's in Nursing, Social Work, or Health Care Administration, or related area is preferred.
• 7-10 years’ experience in Behavioral Health Corporate Compliance or Quality strongly preferred with experience managing RCM billing compliance.
• 3+ years of leadership experience.
• Demonstrated knowledge of State and Federal regulatory requirements.
• Comprehensive understanding of Third-Party Liability, including Medicare and Medicaid, standards.
• Experience in Substance Use Disorder and Medication Assisted Treatment preferred.
• Experience working at a state agency preferred.
• Experience working at a health plan preferred.
• Experience leading the scale of a multi-state Behavioral Health or Healthcare Company strongly preferred with the ability to expedite licensure as needed
• M&A experience a plus.
• Experience with various technology such as AI and ICR to help automate processes a plus.
• Professional certification such as Certified Professional in Healthcare Quality; Certified Professional Healthcare Risk Management; Certified in Healthcare Compliance; or Certified Quality Auditor is required.
• LEAN and/or Six Sigma certification preferred.
• Up to 25% travel.

Tools and Equipment Requirements

• The ability to use a phone, fax, computer, printer, and copier is required.
• Frequent use of Microsoft office products, including but not limited to Outlook, Word, Excel, and PowerPoint.
• The ability to use the internet and various web browser software is required.

Physical Working Conditions and Office Setting Description

• Requires sitting and standing associated with a normal office environment.
• Manual dexterity using a calculator and computer keyboard.
• Requires prolonged sitting, standing, frequent bending, stooping, or stretching.
• Employee must regularly lift and/or move up to 10 pounds, frequently lift and/or move up to 25 pounds and occasionally lift and/or move up to 50 pound

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