Director of Clinical Compliance Audit - Quality

About the Role

Reporting to the Senior Director of Clinical Compliance Audits, the Director of Clinical Compliance Audit – Quality is responsible for directing the Quality auditing program, as well as conducting routine audits or investigations of regulatory quality of care practices related to skilled nursing facilities. This role ensures adherence to federal, state, and local regulations and supports quality improvement initiatives.

Responsibilities

• Develop audit tools to assess facility QAPI programs and quality of care outcomes to identify trends, root causes, and systemic compliance risks associated with resident outcomes.
• Conduct focused audits in response to complaint investigations and survey deficiencies.
• Conduct root cause analyses and develop performance improvement projects to reduce regulatory risk for facilities.
• Support quality of care investigations.
• Partner with Risk Management and Clinical Operations to analyze adverse events and sentinel events for compliance and quality concerns.
• Supervise audit staff and collaborate with operations and other business support staff.
• Apply advanced knowledge and understanding of concepts, principles, and technical capabilities to manage audits, investigations, and education initiatives.

Requirements

• Associate or Bachelor’s degree required; Master’s degree preferred.
• Active RN or other associated healthcare license.
• QAPI Certified Professional (QCP) or Certified Professional in Healthcare Quality (CPHQ) required.
• Certificate in Healthcare Compliance preferred.
• 10+ years experience in clinical practice and progressive regional leadership in a dedicated Quality of Care position.
• Extensive experience conducting clinical record reviews and regulatory investigations.
• Deep knowledge of the conditions of participation for skilled nursing facilities, QAPI, CMS Critical Elements Pathways, CASPER Reports, CMS 5-star Quality rating system.
• Experience leading root-cause analysis (RCA).

Skills

• Strong attention to detail.
• Ability to effectively prioritize and execute tasks in a fast-paced, dynamic environment.
• Excellent time management, personal integrity, and ability to maintain confidentiality.
• Clear verbal and written communication.

Physical Demands

• Primarily sedentary role with extended periods of computer work.
• Occasional standing, walking, and light lifting (up to 10-20 lbs).
• Regular use of hands for typing and office equipment.
• Ability to read and review detailed documents.
• Occasional travel based on business needs (less than 25%).

Pay

Salary Range: $130,000-150,000

Benefits

• Health Coverage: Medical, dental, and vision plans.
• PTO and Vacation: Generous paid time off and holidays.
• Financial Wellness: Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA).
• Retirement Planning: 401(k) plan with company contributions.
• Support When You Need It: Employee Assistance Plan (EAP) for confidential support.