Regional Director of Quality Assurance and Monitoring

About the Role

The Regional Director of Quality Assurance and Monitoring supports regional operations by serving on the Regional Ops team, consulting with and supporting facility Medical Records Directors to achieve operational excellence in records keeping and quality assurance. This role guides, mentors, and develops high-performing medical records professionals and regional support staff, ensuring adherence to medical records best practices.

The RDQAM reports to the Regional Vice President of Operations and has a dotted-line relationship to mentor, educate, and support facility medical records directors and other IDT members.

Responsibilities

• Educates facilities and regional support staff to implement operational Policies & Procedures and best practices developed by the Clinical Strategy and Governance Team.
• Provides consulting oversight, tracks facility Medical Records Directors, assists with orientation of new hires, and coordinates facility leadership.
• Completes on-site facility visits for education and monitoring of trends in documentation to support facility operations.
• Conducts regular monitoring of medical records across multiple facilities to ensure regulatory compliance and documentation accuracy.
• Participates in regular team meetings with SDQAM and other DQAM to address challenges and set goals.
• Reports trends to RVP and Regional Operations Teams and communicates with the SDQAM and PACS Clinical Strategy and Governance Team as needed.
• Coordinates Regional Ops trainings for Medical Records Directors on best practices.
• Ensures Medical Records monitoring tools are utilized to the highest compliance standards for regional facilities.
• Educates and enforces PACS Medical Records Policy and Procedures.
• Develops and distributes Regional medical records reports for quality improvement.
• Assists Regional Support teams and/or company defense attorneys with lawsuits, depositions, reports, and document production for facilities.
• Assists with record requests to ensure complete documents for release and communicates about adverse events or liability concerns.
• Provides Additional Documentation Request (ADR) support and training to Facility Medical Records Directors.
• Provides Triple Check training for Medical Records Directors.
• Supports facilities in preparing for annual surveys and unannounced inspections by ensuring documentation meets state and federal standards.
• Serves as a subject matter expert on HIPAA compliance, privacy regulations, and medical records retention policies.
• Develops and maintains good working rapport with RVP, Regional Ops team, and PACS Clinical Strategy and Governance Team subject matter experts.
• Is proficient with all PACS electronic records systems (e.g., PCC, Nethealth, PointRight, PACS Dashboards).
• Fulfills other assignments as directed by the RVP, including supporting mock surveys and annual surveys at facilities.
• Reports to the Chief Compliance Officer any concerns of compliance, including policies around fraud, waste, and abuse or violations of the PACS Code of Conduct.
• Has dotted-line accountability to the Senior Director of Quality Assurance and Monitoring and must make themselves available for training when requested.

Qualifications

• Bachelor’s degree or higher preferred.
• Proficient in Microsoft Office tools.
• Ability to type 45+ words per minute.
• Strong working knowledge of medical terminology, anatomy and physiology, legal aspects of health information, coding, indexing, etc.
• ICD-10 certified preferred; must obtain certification within 6 months of hire.
• Ability to read, write, speak, and understand the English language, including medical anatomy and technical procedures.
• Ability to apply concepts such as fractions, percentages, ratios, and proportions to practical situations.
• Ability to make independent decisions, solve practical challenges, and interpret instructions in writing, orally, and by diagram.

Physical Demands

• Must be able to move intermittently throughout the workday.
• Must be able to cope with the mental and emotional stress of the position.
• Must possess sight/hearing senses or use prosthetics that enable these senses to function adequately.
• Must be able to push, pull, move, and/or lift a minimum of 25 pounds and carry such weight a minimum distance of 50 feet.

Work Environment

• Work remotely or in a PACS services office or facility.
• Subject to frequent interruptions and occasionally requires work beyond normal hours, such as weekends and holidays.
• Subject to exposure to infectious waste, diseases, conditions, etc., including TB and the AIDS and Hepatitis B viruses.

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.