Quality Management Director

Quality Management Director

Canon Barcus - San Francisco, CA 94103

Salary Range $157,000.00 - $161,576.00 Salary Position Type Full Time

Overview

At Episcopal Community Services (ECS), employees work with participants who may be experiencing homelessness, behavioral health conditions, substance use challenges, and other difficult life circumstances. While this work is meaningful and mission-driven, it can at times be stressful, demanding, or unpredictable. Employees are expected to exercise sound judgment, remain aware of their surroundings, follow established safety, communication, and de-escalation procedures, participate in all required trainings, and promptly report incidents, threats, injuries, or unsafe conditions, in accordance with ECS policies and procedures.

This position is a fully onsite, client-facing role that requires in-person interaction and direct service delivery to participants at ECS program locations. Due to the essential nature of the duties and the need for consistent in-person engagement with clients, remote work or work-from-home arrangements are not available for this position.

External Candidates: $157,000.00

Internal Candidates: $161,576.00

Position Summary

The Quality Management (QM) Director provides strategic and operational leadership for the agency's quality infrastructure, ensuring compliance with MediCal requirements, contractual obligations, accreditation standards, and applicable federal, state, and local regulations. This role leads the organization's compliance function and helps build a culture of accountability, documentation excellence, regulatory readiness, and high-quality program performance. This role oversees compliance activities related to MediCal and CalAIM billing, quality assurance and improvement, contractual and regulatory program requirements, internal standards development and monitoring, policy development, staff training, audits, investigations, and programmatic corrective action planning across the organization.

The QM Director partners closely with program leadership, finance, quality assurance, human resources, legal counsel, and executive leadership to ensure the organization maintains strong internal controls and consistently meets federal, state, county, funder, and organizational standards. The Director supports both fee for service and cost reimbursed programs across multiple counties and service lines to promote a culture of accountability and with a focus on practical implementation, regulatory excellence, risk mitigation, and continuous quality improvement.

Essential Duties and Responsibilities

Organization-wide Compliance Leadership

• Lead the design, implementation, and continuous improvement of the organization's compliance program across all service lines, departments, and operating locations. Develop and maintain a compliance workplan that addresses key regulatory, contractual, operational, documentation, privacy, and billing risks.
• Establish compliance standards, monitoring tools, reporting structures, and internal review processes that support organizational excellence and accountability.
• Serve as an internal subject matter leader on compliance issues affecting nonprofit social services, supportive housing, homelessness programs, county/city contracts, and healthcare-adjacent services.
• Promote a culture in which compliance and accountability are understood as both a regulatory obligation and a driver of quality, performance, and mission effectiveness.
• Ensure timely resolution of compliance issues and sustainable practice changes.

Quality Assurance and Continuous Quality Improvement (CQI)

• Design, implement, and maintain a comprehensive Quality Management and CQI framework aligned with agency goals and regulatory requirements.
• Develop and track key performance indicators, outcomes measures, and compliance metrics across programs in collaboration with the Impact and Analytics team.
• Analyze data trends, identify risks and performance gaps, and recommend improvement strategies.
• Facilitate quality improvement committees and cross functional workgroups.
• Coordinate contract compliance reviews and support corrective actions when deficiencies are identified.

MediCal and CalAIM Compliance

• Oversee compliance related to MediCal, CalAIM, and other healthcare or healthcare adjacent billing requirements, including documentation integrity, service authorization, record completeness, proper claiming procedures and adherence to applicable standards.
• Partner with finance, revenue cycle, program operations, and clinical or service leadership to strengthen billing compliance systems and reduce repayment, disallowance, and audit risk.
• Provide direct oversight of MediCal billing practices, including collaboration with finance and billing teams to ensure accuracy, timeliness, and compliance.
• Monitor regulatory updates affecting MediCal and CalAIM services and translate changes into operational guidance, training, and internal controls while communicating changes and their impact to program and executive leadership.
• Review billing related compliance trends, audit findings, and documentation issues and implement corrective actions as needed.
• Support readiness lead preparation for and provide response to county, state, managed care, and payer audits or reviews.

Programmatic and Operational Compliance

• Oversee compliance monitoring for programs that do not bill Medi-Cal, including grant-funded, contract-funded, housing, shelter, employment, outreach, and other community-based services.
• Ensure programs have appropriate systems for documentation, eligibility determination, service tracking, performance reporting, confidentiality, incident reporting, and contract compliance.
• Partner with operational leaders to identify compliance vulnerabilities and strengthen standard practices across programs and sites.
• Coordinate compliance review activities related to funder requirements, county contracts, licensing or certification standards where applicable, and organizational policies.
• Coordinate contract compliance reviews and support corrective actions when deficiencies are identified.
• Oversee compliance with all programmatic contracts, including government and managed care agreements. Track corrective action plans and provide follow-up to ensure timely resolution of identified issues.

Audits, Investigations, and Risk Management

• Lead or coordinate internal compliance audits, focused reviews, and monitoring activities.
• Respond to compliance concerns, allegations, or suspected violations in partnership with leadership, human resources, legal counsel, and other relevant parties.
• Review, draft, and/or coordinate written action plans and corrective action responses to funders, county partners, payers, and regulatory agencies.
• Maintain systems for documenting findings, investigations, action plans, and resolution steps.
• Prepare the organization for external audits, monitoring visits, and funder or regulatory reviews.
• Identify enterprise compliance risks and regularly report trends, issues, and recommendations to executive leadership.
• Identify systemic risks and work with leadership to implement preventative and corrective measures.

Accreditation and External Review Activities

• Lead agency accreditation efforts (e.g., CARF, COA, Joint Commission, or other applicable bodies).
• Coordinate accreditation readiness, self assessments, documentation, and site visit preparation.
• Serve as primary liaison with accrediting bodies and oversee post survey improvement activities.

Policies, Training, and Infrastructure

• Lead the development, review, and maintenance of agency wide policies and procedures to ensure regulatory and contractual compliance.
• Develop, revise, and implement program specific compliance related policies, procedures, and guidance documents when necessary.
• Establish policy governance processes, including version control, review cycles, and staff dissemination.
• Ensure policies support best practices, ethical standards, and trauma informed service delivery.
• Develop and oversee agency wide and program specific training programs, including provision of guidance and technical assistance to leadership, managers, and frontline staff.
• Promote staff understanding of compliance responsibilities and quality expectations across all programs. Design and deliver staff training on documentation standards, privacy, billing integrity, program requirements, internal controls, and other compliance topics.
• Build practical compliance tools that support staff in meeting expectations consistently across departments and counties.
• Help define clear roles, accountability structures, and escalation pathways for compliance issues.

Leadership and Collaboration

• Supervise and mentor quality assurance, training and compliance team members and support their professional development.
• Partner closely and foster collaborative relationships with program directors, finance staff, quality teams, executives and other internal and external stakeholders to align compliance expectations with operational reality.
• Serve as a key advisor to executive leadership on quality, compliance, and regulatory risk issues, including routine presentations on compliance updates, risks, and recommendations to executive leadership and, as requested, board committees.
• Serve as a trusted, solutions-oriented partner who can balance regulatory rigor with mission-centered service delivery.

Qualifications

Minimum Qualifications

• Bachelor's degree required; advanced

Episcopal Community Services of San Francisco