Asst Dir, Qual&Compliance,EIOH

As a community, the University of Rochester is defined by a deep commitment to Meliora - Ever Better. Embedded in that ideal are the values we share: equity, leadership, integrity, openness, respect, and accountability. Together, we will set the highest standards for how we treat each other to ensure our community is welcoming to all and is a place where all can thrive.

Job Location (Full Address):

625 Elmwood Ave, Rochester, New York, United States of America, 14642

Opening:

Worker Subtype:

Regular

Time Type:

Full time

Scheduled Weekly Hours:

40

Department:

920700 EIOH Finance & Admin

Work Shift:

UR - Day (United States of America)

Range:

UR URC 216

Compensation Range:

$83,537.00 - $116,964.00

The referenced pay range represents the minimum and maximum compensation for this job. Individual annual salaries/hourly rates will be set within the job's compensation range, and will be determined by considering factors including, but not limited to, market data, education, experience, qualifications, expertise of the individual, and internal equity considerations.

Responsibilities:

GENERAL PURPOSE
Provides leadership to further the strategic agenda of the office for Quality Improvement and Compliance (OQIC) for all EIOH departments, including Eastman Dental site, various Community Dentistry sites, and the University Dental Faculty Group. Provides strategic leadership with the capacity to guide, interpret, revise, and implement compliance matters, quality improvement, risk management, safety, HIPAA, accreditation, and infection control policies and operations consistent with State of New York Official Compilation of Codes, Rules, and Regulations (10 NYCRR). Oversees assigned staff that provide support to these systems and operational workflows. Provides information for institutional planning to prevent, minimize, eliminate or rectify non-compliant situations. Responsible for delivering a multifaceted educational and training program that focuses on all elements of the quality, compliance and safety programs, and seeks to ensure all appropriate employees, students, residents, faculty and management are knowledgeable of and compliant with pertinent federal and state standards.

ESSENTIAL FUNCTIONS

• Directs the implementation of quality improvement efforts designed to improve clinical performance and maintain compliance with NYSDOH, JCAHO, HIPAA, and other accreditation standards.
• Works collaboratively with quality leadership, quality team, social work, faculty, risk management, and other senior leadership to develop short- and long-term goals and objectives that are in alignment with the Medical Center and department goals.
• Directs and monitors key performance indicators (KPIs) to assess the effectiveness of quality improvement efforts.
• Analyzes data trends to identify areas for improvement and implement data-driven decision-making processes.
• Guides leadership on dental quality policies and initiatives.
• Develops programs and processes to manage complaint cases brought to regulatory authorities and develops process improvements to avoid future complaints.
• Directs compliance with regulatory and accreditation requirements for monitoring and evaluation of patient care, incident reporting/review, risk management, safety management, and education processes and the coordination of record management.
• Provides direction to ensure departments meet the requirements of applicable laws, regulations and standards related to clinical operations and billing compliance.
• Directs the response and follow-up to adverse events, patient harm, and near misses.
• Works collaboratively with the URMC Chief Compliance Officer, EIOH Medical Director, and UR Office of Counsel to facilitate the execution of the Root Cause Analysis (RCA) process.
• Oversees, directs, delivers all information to the NYS Health Commerce System and Health Emergency Response Data System, including but not limited to, patient transfers, RCAs, and employee vaccination status.
• Manages responses to certain requests for medical record and/or subpoenas from the NY Department of Health Information, CMS, and OIG.
• Works collaboratively with Health Information Management on cases that include both dental services and medical care, encompassing electronic health record systems. Oversees internal review of clinical billing to determine compliance with billing policies and procedures, including in-depth reviews of dental and medical record chart documentation, to ensure compliance with HCFA guidelines and chart documentation supports the designed billing level.
• Serves as the primary point of contact for federal, state, and governmental