Director Quality Improvement and Compliance

Company: Miami Jewish Health
Location: Miami
Posted on: March 5, 2025

Job Description:

• Location: 5200 NE 2nd Ave, Miami, FL, 33137, United States
• Employee Type: Full-TimeContact information
  • Name: Yuleysys Alfayate, Director Talent Acquisition
  • Phone: (305) 985-1880DescriptionMiami Jewish Health is one of the largest providers of healthcare and living options for aging adults in the Southeast. We operate Florida PACE (Program of All-Inclusive Care for the Elderly) Centers, the largest PACE program in Florida, which serves as health plan, healthcare provider, and social center designed for older adults with complex medical needs. We have four adult day health centers that serve participants in Miami-Dade and Broward counties.Our careers are challenging, meaningful and rewarding. Join us now to do purposeful work in supporting our community's seniors and their families.Job Title: Director Quality Improvement and Compliance (Florida PACE Centers)Job SummaryThis position oversees the Florida PACE (Program of All-inclusive Care for the Elderly) Centers (FPC), Inc. performance improvement activities by adapting and implementing PACE Performance Improvement Plan, policies and procedures that will ensure all PACE sites compliance with CMS, AHCA, and Health Insurance Portability and Accountability Act (HIPAA) regulations. The Director will also be responsible to design a process that will comply with all the applicable state, federal, and local statutes pertaining to PACE regulation; Works directly under the AVP of PACE on all aspects of planning, developing and implementing Compliance and Quality standards across multiple locations within the program. Facilitates and coordinates Florida PACE (Program of All-inclusive Care for the Elderly) Centers (FPC), Inc Quality Program to assure compliance with CMS, AHCA, DOEA and other health care accrediting standards for Quality Improvement in order to enhance the quality of client and participant care under the CMS PACE regulations.Essential Job Functions
    • Develops and leads the compliance program, including the committee and all regulatory changes required by the compliance plan and the OIG WorkPlan for all.
    • Facilitates internal compliance with requirements of accrediting and regulatory agencies and provides procedural and strategic guidance and oversight to FPC.
    • Serves as Privacy Officer for FPC.
    • Oversees contract management program for FPC.
    • Aligns and develops FPC policies and procedures in accordance with compliance, legal and strategic objectives. Maintains database of policies and procedures and oversees administration of such.
    • Oversees and provides guidance and training to Compliance department. Responsible for managing all internal compliance activities and reporting to regulatory agencies.
    • Develops in collaboration with AVP, General Counsel, Medical Directors and Chief Medical Officer the Annual Compliance Plan.
    • Represents FPC at meetings and conferences, as necessary.
    • Maintains up to date knowledge of current trends, laws, and philosophies in regard to PACE and healthcare and management.
    • Develops, implements, and oversees the application of an electronic health record. Interfaces with clinical staff to ensure compliance with all regulatory requirements.
    • Performs all other related duties as required.Job RequirementsEducation:
      • Bachelor's DegreeExperience:
        • Five years or more experience in the Quality Assurance/Pl or risk managementLicenses/Certifications:
          • Certified Professional in Healthcare Quality (CPHQ) preferred
          • Valid Florida Driver's License and Proof of Insurance requiredAbilities Required:
            • Computer knowledge; Power Point, Excel, Visio, Word, Policy Tech, MS Outlook.
            • Customer Service Skills
            • Bilingual: English and Spanish/Creole
            • Regulatory and Accredited Agencies Expertise: AHCA, CMS, DOEA, etc.Functional DemandsEnvironment Work Conditions:
              • Normal working condition with adequate lighting and ventilation.Infectious Material Exposure:
                • No routine exposure to blood/body fluids/tissues, but may occasionally require performing unplanned activities which may involve exposure to blood/body fluids/tissues.Organizational Expectations:
                  • Ensures that resident's/patient's rights are adhered to.
                  • Demonstrates professionalism and accountability.
                  • Demonstrates a caring attitude consistent with Miami Jewish Empathicare SM toward MJH residents, patients, family members, employees, and other facility guests.
                  • Demonstrates excellent communication skills.
                  • Ensures confidentiality and security of patients' medical information.
                  • Identifies and utilizes appropriate channels of communication.
                  • Able to speak, read and write English.
                  • Able to think and act calmly to meet unusual occurrences of the job.
                  • Adheres to the organization's Mission, Vision and Values.
                  • Participates in departmental activities, meetings and in-services and follows established guidelines.
                  • Maintains a safe working environment.The above statements are intended to describe the general nature and level of work being performed by people assigned to this job. They are not to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified. All personnel may be required to perform duties outside of their normal responsibilities from time to time, as needed.We believe in the power of empathy, the value of relationships and the importance of a life well-lived. Come see why Miami Jewish Health is unlike anywhere you've ever worked before. We offer competitive compensation, medical/dental/vision coverage and a 403(b)-retirement savings plan for eligible full and part-time positions, free on-campus parking, an onsite fitness center and more.Miami Jewish Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.
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Keywords: Miami Jewish Health, Miami , Director Quality Improvement and Compliance, Executive , Miami, Florida