Compliance and Quality Assurance Manager

at  Southwest Human Development Inc

A POSITIVE FUTURE FOR EVERY CHILD

Southwest Human Development is Arizona’s largest nonprofit dedicated to early childhood development. The first five years of life are the most critical in a child’s development. At Southwest Human Development, our services improve lives and help families by supporting young children and their caregivers during this important time.
Your skills, experience, and passion are needed at one of the nation’s largest nonprofits dedicated to early childhood development. Join our team and experience a long-term career that brings joy and satisfaction in knowing you make a difference. We offer over 40 programs and services to more than 140,000 children.

EXPERIENCE

Required

• Proficient in the Microsoft Office Suite: Excel, Word, etc.
• Health field areas, including medical and behavioral health experience, with a deep understanding of quality improvement strategies is preferred for this position
• Medicaid (specifically AHCCCS).
• Value-based programming and payment.
• Working with electronic record systems (EMR/EHR) – comprehensive applications, data management and reporting.
• 5 year(s): Healthcare industry with responsibility for quality improvement, data analysis and outcome measures. This includes a demonstrated ability to develop, implement, and manage a quality management program.

EDUCATION

Required

• Masters or better in Health Administration or related field

• Oversee the compliance program
• Lead the charge in preparing for regulatory audits, reviews, reports, studies, and site visits, ensuring our department exceeds regulatory expectations.
• Collaborate closely with our HIPAA compliance officer to safeguard client-protected health information, upholding the utmost confidentiality and trust.
• Be the face of our organization in regional health plan meetings, liaising with contractors and stakeholders to foster strong, compliant partnerships.
• Monitor and coordinate compliance activities, providing vital status updates and identifying trends to keep us ahead of the curve.
• Proactively identify areas of compliance vulnerability, crafting and implementing corrective action plans to resolve issues and prevent future occurrences.
• Manage and leverage our Learning Management Platforms, ensuring training requirements are met with efficiency and effectiveness.
• Oversee the provider credentialing process, maintaining the highest standards of qualification and excellence.
• Maintain and manage our policy library, ensuring all documentation is up-to-date and in line with organizational and program leadership directives.
• Oversee the quality program
• Take the lead in developing, implementing, and overseeing a robust quality program, designed to elevate clinical performance and meet internal and regulatory goals.
• Provide strategic support to achieve quality and department goals, identifying and implementing performance quality improvement efforts.
• Establish and monitor key performance indicators, ensuring progress toward contractual metric targets and departmental objectives.
• Manage project implementation related to new data, performance improvement, or regulatory requirements, ensuring seamless integration and success.
• Develop and execute short- and long-term strategies, implementing quality improvement suggestions to meet and exceed contractual requirements and KPIs.
• Play a pivotal role in quality improvement projects and campaigns, leading the way in setting industry standards.
  SWHD takes the health and safety of our employees and the communities we serve very seriously. We strongly believe vaccination is a critical safety measure to protect each of us and the communities we serve. COVID vaccinations have proven to be highly effective at protecting people from getting COVID-19 or from getting severely ill from it.