Regional Director of Quality & Compliance - PACE

About the Job

We truly value our employees and are committed to their success! We offer long-term employment opportunities with job stability, as well as support and encouragement for career growth and advancement. Our comprehensive benefits package includes Health, Dental, and Vision insurance, Paid Time Off, 9 Paid Holidays, a 403(b) Retirement Plan with company matching, and company-paid Life Insurance. Join our team and experience a workplace culture that fosters teamwork, growth, and support!

Los Angeles Jewish Health has been a trusted provider of senior healthcare for over 100 years, offering a wide range of services that prioritize excellence and Jewish values. We serve more than 4,000 seniors across our San Fernando Valley campuses, delivering personalized care tailored to each individual's needs, from independent living to specialized healthcare programs.

The Brandman Centers for Senior Care (BCSC), a Program of All-inclusive Care for the Elderly (PACE), provides high-quality, comprehensive healthcare services. We are a program of Los Angeles Jewish Health, renowned for providing quality care to vulnerable seniors.

The responsibilities of the Regional Director of Quality & Compliance include, but are not limited to:

Responsibilities:

• Ensures site readiness review is achieved by milestones.
• Accountable for completion of all mock audits.
• Effectively manage CAPs for operational excellence.
• Manages all aspects of QI program and other review processes to ensure quality Participant care.
• Ensures compliance with all State and Federal regulations regarding PACE services.
• Interpret and ensure compliance with federal/state laws and CMS standards, serving as the subject matter expert.
• Serves as National PACE Association (NPA) representative for all quality related activities.
• Supervises the Director of Quality and Compliance.
• Works closely with the Medical Director, Director of Operations, and Interdisciplinary team (IDT) to identify standards, develop indicators, collect and analyze data and provide corrective action to improve performance.
• Lead internal and external audits, including CMS site visits, and manage corrective action plans (CAPs).
• Coordinates and facilitates QI meetings and all PACE Committee and Sub-Committees. Presents detailed and complete reports at selected committees leading quality related discussions.
• Provides oversight and direction for The Director of Analytics and development.
• Facilitates ad hoc workgroups for the development of policies, procedures, protocols, flowcharts and other job aids.
• Organizes and serves as project lead for audits by regulatory agencies. Develops tools to aid in preparation for audits; monitors progress of audit preparation; provides onsite direction for reviewers; and ensures timely submission and communication with regulators agencies regarding the audits.
• In collaboration with the Los Angeles Jewish Health (LAJH) Compliance Program, designs, organizes and implements the PACE Compliance Program. Monitors and measures compliance issues, CAPs, and the Fraud, Waste, and Abuse (FWA) Program. Receives and documents reports of conflict of interest and non-compliance.
• Participates as a member of the BCSC PACE Management Team.
• Aggregates and analyzes information on indicators of Participant risk and the care process as part of the QI program and provides reports to members of the Quality Improvement Committee and other members of the management team.
• Oversees the annual QI Plan update and works closely with the PACE Medical Director, Director of Operations, and IDT to identify standards, develop indicators, collect and analyze data and provide corrective action plans to improve performance.
• Oversees completion of Participant and caregiver satisfaction surveys.
• Development of Annual QI Work Plan with BCSC Medical Director.
• Coordinates quality improvement activities related to new enrollees and voluntary and involuntary disenrollments. Works closely with the Director of Operations and Center Directors to receive, document and resolve reports of Participant rights violations, grievances, appeals and other issues related to services and quality of care.
• Reports PACE Quality Monitoring and Reporting Guidance regarding incidents to regulatory agencies, as required, and oversees Root Cause Analysis to prepare timely submissions to CMS.
• Educates and assists PACE BCSC physicians and staff regarding QI Program initiatives.
• Reports to the Center Directors any discrepancies in processes and systems that might present a compliance or regulatory concern, suggests process improvement remedies, and coordinates improvement team efforts.
• Coordinates and assists to ensure staff educational programs are in place and implemented.
• Conducts audits to ensure compliance with educational requests.

Education & Experience:

• Degrees and Diplomas: Master's degree in Nursing, Public Health, Quality Management, Health Care Management or related field. RN preferred.
• Certificates, Licenses: Must have a valid California driver's license. TB screening and successful completion of a health examination by a health care provider is required for employment.
• Experience: Minimum of five years of experience in management. Minimum of two years in the quality improvement area. Professional experience administering, collecting and analyzing data and survey results.
• Skills/Aptitudes: Excellent management and communication skills. Ability to handle complex interpersonal situations.

Join Los Angeles Jewish Health and make a meaningful impact in the lives of seniors in our community. Become part of our compassionate team, dedicated to providing exceptional care and support. Apply today and start making a difference!

About the Company

Los Angeles Jewish Health is dedicated to providing exceptional, comprehensive senior healthcare services, guided by our mission to deliver excellence in care for all, rooted in Jewish values. With over 100 years of trusted service to seniors, we continuously evolve to meet the unique needs of every individual we serve.As the largest single-source senior housing provider in Los Angeles, our San Fernando Valley campuses are home to over 1,000 residents. We serve more than 4,000 seniors through a range of healthcare programs, offering independent living options for those who seek the reassurance of support when needed. From adult day care to residential living, and short-term or long-term care, we tailor each senior's experience to their specific needs, ensuring personalized care at every stage of life.