Job Summary Responsible for ensuring clinical processes are conducted in accordance with guidelines and regulations. Develops, performs, and manages quality assurance activities. Presides over audits. Duties and Responsibilities Monitor, track and coordinate with the appropriate management staff to ensure QA compliance with contract and CMS deliverables.Conduct quality improvement studies as required for assigned client or customers, both internal and externalManage and maintain databases for the quality system.Prepare and assist in preparing annual reports and quality trending reports.Report the status of the quality levels of staff, systems and production activities.Compile documentation and perform audits of coverage determination and redetermination activitiesEvaluate quality events, incidents, queries, and complaints.Keep up to date with all related quality legislation and compliance issuesEstablish and maintain a quality improvement reporting and measurement system for clinical operationsDocument internal regulatory processes.Ensure regulatory rules are communicated through corporate policies and procedures.Utilize guidance documents, international standards, or consensus standards and interpret for guidance.Ensure that investigator, vendor, facility and system audits are conducted.Communicate any critical compliance risks noted from these activities to senior management.Identify and trend potential problems and areas for performance improvementSupports and executes the mission, ethics, and goals of the company effectively.Represents themselves in a positive and professional manner in the company and community.Adheres to dress code with a clean and neat professional appearance.Reports on time and as scheduled in order to complete work within designated time.Adhere to all company policies and procedures outlined in Employee Handbook, Employee Agreement, or communicated from executive team.
