Associate, Quality and Compliance

Description
Company: Oak Street Health
Title: Associate, Quality and Compliance
Location: Headquarter/Remote
The mission of Oak Street Health is to rebuild healthcare as it should be.
We are a rapidly growing, innovative company of community-based healthcare centers delivering higher quality health and wellness care that improves outcomes, manages medical costs and provides an unmatched experience for adults on Medicare.
The Oak Street model integrates outstanding clinical expertise, technology, and teamwork to deliver improved care quality and cost savings. These cost savings are then reinvested into care in our communities, creating a virtuous cycle of improving community health.
We are a national organization serving over 100,000 patients and we are growing rapidly . We are a diverse team of care providers, service team members, technologists, community outreach experts, business professionals, and more -- all dedicated to our Oaky Values and motivated by our mission. We're looking forward to getting to know you!
For more information, visit www.oakstreethealth.com.
Role description:
The Quality & Compliance Associate is accountable for internal case management and utilization management compliance, implementing and monitoring ongoing quality improvement activities, and using oversight programs to make recommendations to operations teams. This position assesses compliance with departmental, regulatory, and accrediting requirements. The Quality & Compliance Associate serves as a resource to internal ancillary departments on quality and utilization issues and works with department leadership on recommendations for staff and program improvements. In addition, the Associate leads external compliance and accreditation survey processes. This position applies program knowledge and analytical skills to effectively coordinate quality activities and achieve performance metrics of organizational goals.
Responsibilities:

• Possesses and demonstrates knowledge of CMS, contractual, accreditation, federal, state, and business requirements for assigned programs, and ensures compliance with program requirements
• Collaborates with leadership to develop, implement, and maintain policies and procedures for assigned programs
• Collaborates with leadership to develop and execute auditing and monitoring tools utilized for staff and program audits
• Contributes to reports used by internal and external leadership
• Provides input and valuable feedback on auditing results, trends and improvement activities
• Recommends process improvement interventions and assists with implementation
• Develops and revises training materials based on QA results
• Analyzes processes and key performance indicators to assess compliance risk, internal control, and overall effectiveness and efficiency
• Consistently demonstrates compliance with HIPAA regulations, professional conduct, and ethical practices
• Develops Corrective Action Plans (CAPs) and Performance Improvement Plans (PIPs) and is accountable for the adequacy of operational responses and ongoing monitoring
• Performs other job duties, as assigned.

What we're looking for

• Bachelor's degree in Healthcare Administration, Compliance, related field, or equivalent experience
• Minimum of 2 of years of compliance experience dealing with care management requirements, utilization management requirements, auditing, reporting processes, action plans, and compliance training
• Strong understanding of healthcare laws, NCQA requirements, and Medicare Part C regulatory compliance in a managed care organization or hospital health care system setting
• Experience working with regulators on compliance audits
• Ability to work independently and with others
• Experience in building and supporting strong teamwork and collaborative communication
• Ability to work under pressure with multiple deadlines and priorities
• Strong problem-solving skills, critical thinking skills, and organizational skills
• US work authorization
• Someone who embodies "Being Oaky"

What does being "Oaky" look like?

• Radiating positive energy
• Assuming good intentions
• Creating an unmatched patient experience
• Driving clinical excellence
• Taking ownership and delivering results
• Being scrappy

Why Oak Street?
Oak Street Health offers our coworkers the opportunity to be at the forefront of a revolution in healthcare, as well as:

• Collaborative and energetic culture
• Fast-paced and innovative environment
• Competitive benefits including paid vacation and sick time, generous 401K match with immediate vesting, and health benefits

Oak Street Health is an equal opportunity employer. We embrace diversity and encourage all interested readers to apply to oakstreethealth.com/careers.