Compliance and Outcomes Manager
Albuquerque, NM
Full Time
Manager/Supervisor
***Signing Bonus $1500
Sign-On Bonus for Bilingual Applicants: $1,500 (Distributed in 3 parts: $500 after 30 days, $500 after 6 months, and $500 after 12 months of employment)
JOB TITLE: Compliance and Outcomes Manager
LOCATION: Gateway Medical Sobering- Albuquerque, New Mexico
Who are we?
Horizon Services, Inc. (HSI) is a nonprofit established in 1974 that offers addiction treatment with the goal of reducing substance use and mental health related challenges for people from all walks of life, including those from some of the most disenfranchised and marginalized communities. We practice our values of Integrity, Respect, Professionalism, and Compassion to provide youth prevention, youth and adult outpatient, sobering programs, withdrawal management, and co-occurring capable residential programs to support the well-being of women, men, youth, LGBTQIA+, and BIPOC clients to live healthy, fulfilling and constructive lives. HSI is an inclusive workplace and a learning community where our collective experiences
enrich each other’s growth.
The Compliance and Outcomes Manager implements all policies, procedures and best practices ensuring all treatment at all levels are compliant with contractual, State, and Federal guidelines and providing the best care for our clients. The individual in this role will also monitor, track appropriate systems, and tools to ensure quality assurance/safety and deliverables are met.
How can you make a difference in people’s lives?
In this role, you’ll make a difference in the lives of people with substance abuse challenges, and often with co-occurring conditions. You’ll use and grow your skills in compassionate care, crisis intervention and de-escalation, in a supportive and inclusive work environment. You’ll have the opportunity to provide our community with substance abuse treatment to help people who are just discovering possibilities in their journey, going from a place of hopelessness to a place where they are valued and have the potential for a better life.
PRIMARY ACCOUNTABILITIES & RESPONSIBILITIES
Accountabilities:
Responsibilities:
Quality Assurance/Quality Improvement (QAQI)
Utilization Management
DISC Behavior/Communication Strengths:
What else is required?
Compensation and Benefits
We are proud to offer a comprehensive benefits package to all full-time and part-time employees over 20 hours per week.
Salary: : $49,920K-$62,400K/ annually based on experience and qualifications. Available for a full-time position.
Horizon Services, Inc. is an Equal Opportunity Employer.
https://www.horizonservices.org
Sign-On Bonus for Bilingual Applicants: $1,500 (Distributed in 3 parts: $500 after 30 days, $500 after 6 months, and $500 after 12 months of employment)
JOB TITLE: Compliance and Outcomes Manager
LOCATION: Gateway Medical Sobering- Albuquerque, New Mexico
Who are we?
Horizon Services, Inc. (HSI) is a nonprofit established in 1974 that offers addiction treatment with the goal of reducing substance use and mental health related challenges for people from all walks of life, including those from some of the most disenfranchised and marginalized communities. We practice our values of Integrity, Respect, Professionalism, and Compassion to provide youth prevention, youth and adult outpatient, sobering programs, withdrawal management, and co-occurring capable residential programs to support the well-being of women, men, youth, LGBTQIA+, and BIPOC clients to live healthy, fulfilling and constructive lives. HSI is an inclusive workplace and a learning community where our collective experiences
enrich each other’s growth.
The Compliance and Outcomes Manager implements all policies, procedures and best practices ensuring all treatment at all levels are compliant with contractual, State, and Federal guidelines and providing the best care for our clients. The individual in this role will also monitor, track appropriate systems, and tools to ensure quality assurance/safety and deliverables are met.
How can you make a difference in people’s lives?
In this role, you’ll make a difference in the lives of people with substance abuse challenges, and often with co-occurring conditions. You’ll use and grow your skills in compassionate care, crisis intervention and de-escalation, in a supportive and inclusive work environment. You’ll have the opportunity to provide our community with substance abuse treatment to help people who are just discovering possibilities in their journey, going from a place of hopelessness to a place where they are valued and have the potential for a better life.
PRIMARY ACCOUNTABILITIES & RESPONSIBILITIES
Accountabilities:
- Quality Assurance/Quality Improvement (QAQI)
- Measuring Outcomes & Data Management
- Program Contractual Compliance
- Facilities Safety, Quality. Facilities Repair & Maintenance (R&M). Facilities Management & Special Projects.
- Accreditation
Responsibilities:
Quality Assurance/Quality Improvement (QAQI)
- Under the direction of the Program Manager, the Compliance and Outcomes Manager coordinates, implements, and oversees the Quality Assurance and Quality Improvement (QAQI) functions for the assigned program(s) or line(s) of service.
- Provide day-to-day implementation and management of QAQI functions for assigned program(s), including but not limited to conducting clinical documentation audits, routine patient chart reviews, environment of care quality monitoring and improvement assessments, and coordination with stakeholder QAQI department authorities.
- Provides monthly QAQI reports to Program Manager. Reports include review and identification of potential deficiencies within clinical documentation and patient charts, environment of care quality, and outcome data quality.
- Coordinates with Program Manager to ensure effective implementation and monitoring of QAQI functions at the assigned program(s).
- Coordinates and facilitates QAQI inspections, chart reviews, and reporting to oversight agencies and participates in external auditing processes for assigned program(s). Develops audit response documentation, including corrective action plans (CAPs) and performance improvement plans (PIPs) and submits to Program Manager and CSGSO for approval before submission. Performs timely completion and documentation of corrective actions and implements mechanisms to avoid repetition of negative audit findings.
- Assists the Program Manager and CSGSO to develop and implement policies, procedures, tools, protocols, and QAQI calendars to enhance productivity, performance, and efficiency related to QAQI functions.
- Serves as primary point of contact for oversight agencies for assigned program(s) and manages stakeholder communications related to QAQI functions under direction of Program Manager and CSGSO. Regularly attends QAQI meetings with funders and external stakeholders and communicates any updates or changes to staff at assigned program(s). Summarizes and relays this information to the Administrator.
- Coordinates with Program Manager for assigned program(s) to recommend improvements and corrective actions to be implemented at the assigned program(s).
- Gather and manage program data used to enhance service delivery, QAQI functions, strategic planning, regulatory compliance, client outcomes, and client satisfaction. Coordinates with IS Department as these processes relate to electronic systems.
- Analyzes and summarizes gathered data for assigned program(s) and reports to Program Manager and CSGSO, and assists in the development of improvement recommendations to agency leadership.
- Generates QAQI, outcomes, and program compliance reports and deliverables for Program manager and CSGSO to compile and report to agency leadership. Ensures data integrity and availability for assigned program(s).
- Assist with development of procedures to collect regular feedback from clients, staff, and other stakeholders. Implement feedback mechanisms for assigned program(s).
- Serve as designated Privacy Officer for assigned program(s) and monitor compliance with all data security and privacy standards as defined by HIPAA, 42 CFR, and related County, State, and Federal privacy rules. Respond to requests for records and address any privacy/security related grievances or complaints under direction from Program Manager and CSGSO.
- Under the direction of Program Manager and CSGSO, develops, coordinates, implements, and monitors the maintenance of program contractual functions for assigned programs.
- For assigned program(s), monitor and maintain all documentation pertaining to staff certification and licensing, TB testing and health screening, CPR and First Aid Certification, staff identification, insurance, and all other credentialing and personnel file requirements as defined by regulatory oversight agencies and stakeholders.
- Provide copies of credential documents to Human Resources. Coordinates with Program Manager on corrective actions related to personnel credentialing and record maintenance.
- Reports program licensing compliance deficiencies identified through routine monitoring of program operations and documentation to Administrator on a monthly basis and coordinates with Program Manager(s) for assigned programs to ensure timely correction and resolution of deficiencies prior to audit.
- Coordinates program inspections and facilitates external auditing processes. Develops written responses to audit reports, including corrective action plans (CAPs) and performance improvement plans (PIPs). Ensures timely completion and documentation of corrective actions and implements mechanisms to avoid repetition of negative audit findings.
- Assist program development of policies, procedures, tools, calendars, and protocols to enhance licensing compliance operations for assigned programs.
- Conduct routine, unannounced internal audits, including chart reviews, for program licensing compliance and communicate any findings to CSGSO and Program Manager in order to coordinate prompt resolution to identified deficiencies.
- Participate in weekly meetings with Program Leadership to coordinate program compliance efforts, develop improved monitoring practices, and receive regular feedback related to ongoing compliance issues.
- Maintain expert knowledge regarding program compliance standards and other stakeholder agencies when applicable.
- Leverages the support of the ADPOSS to ensure facilities are adequately maintained.
- Ensures the successful operation of a ticketing system to organize and prioritize repairs
- Assist CSGSO and Program Manager in developing vendor partnerships to maximize quality, cost & turn-around on repairs
- Maximizes facility safety via the fast turn-around of necessary repair & maintenance
- Under direction of CSGSO and Program Manager , develops, coordinates, implements, and monitors the maintenance of contract compliance functions for assigned programs.
- Reports contract compliance deficiencies identified through routine monitoring of program operations and documentation to Administrator on a monthly basis. Coordinates with Program Manager(s) for assigned programs to ensure timely correction and resolution of deficiencies prior to audit.
- Coordinates contract inspections and facilitate external auditing processes. Develop written responses to audit reports, including corrective action plans (CAPs) and performance improvement plans (PIPs). Ensures timely completion and documentation of corrective actions and implements mechanisms to avoid repetition of negative audit findings.
- Assist in the development of policies, procedures, tools, calendars, and protocols to enhance contract compliance operations for assigned programs.
- Coordinate with Program Managers to support their communications with contract agencies to maintain strong stakeholder relationships and address updates to contract requirements/deliverables for assigned programs.
- Conduct routine, unannounced internal audits, including chart reviews, for contract compliance and communicate any findings to in order to coordinate prompt resolution to identify deficiencies.
- Participate in weekly meetings with Program Leadership to coordinate contract compliance efforts across the organization, develop improved monitoring practices, and receive regular feedback related to ongoing compliance issues.
- Maintain expert knowledge regarding contract compliance standards as defined by contracting agencies. Coordinate with CSGSO and Program Manager to educate staff and ensure program operations remain consistent with current standards. Assist in the planning, coordination, and facilitation of organizational trainings or other communications needed to ensure ongoing contract compliance.
Utilization Management
- Monitor, and manage collection of utilization management (UM) data for assigned program(s). Report UM data and make recommendations to ensure census goals are met and maintained for assigned program(s). Address and resolve UM data integrity and management issues as needed.
- Implement, monitor, and make corrective actions as needed to track individual client service authorizations and provide regular notifications to program staff to support timely authorization renewal to avoid lapse in services for assigned program clientele.
- Responsible for collecting, organizing, and reporting program census data, reconciliation of services with billing entries in electronic systems, and other program UM, census, revenue, or service-related data. Data reported to the Finance Department is timely and accurate.
DISC Behavior/Communication Strengths:
- Driven: Having a hard-charging approach, showing a sense of urgency and focusing on swift results, which is crucial for leadership and decision-making.
- Daring: Being comfortable with taking risks and pitching bold ideas. This trait is important for
- Forceful: Is outspoken, assertive, and willing to advocate strongly for beliefs. This trait is needed in roles where strong leadership and decision-making are required.
- Accommodating: be adaptable and open to others' input, this trait balances assertiveness, Frank: communicates directly and gets to the point quickly. This honesty and clarity are valuable for effective leadership and transparent communication.
- Skeptical: questioning and cautious when evaluating new ideas. This trait helps in making well-considered decisions, ensuring that potential risks are carefully analyzed
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What else is required?
- BA degree or equivalent training/experience as described below.
- Preferred 2 + years of substance use disorder, mental health, or similar Quality Assurance and Compliance
- Preferred, SUD or mental health certification with state certifying organization or professional board.
- Fluency in at least one of New Mexico threshold languages (Vietnamese, Mandarin, Cantonese, Dari, Arabic, Swahili, Kinyarwanda, and Diné (Navajo)
Compensation and Benefits
We are proud to offer a comprehensive benefits package to all full-time and part-time employees over 20 hours per week.
- Generous contribution medical, dental, Life and LTD for the employee and 50% for any dependent medical and dental coverage.
- PTO and Holiday pay.
- Retirement benefits after 6 months of service.
- Training and CEU opportunities.
Salary: : $49,920K-$62,400K/ annually based on experience and qualifications. Available for a full-time position.
Horizon Services, Inc. is an Equal Opportunity Employer.
https://www.horizonservices.org
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