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Spaulding Rehabilitation Hospital Boston - Boston/Main Campus, MA US
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Department: Quality and Compliance; Regulatory Affairs
General Summary/ Overview Statement
The Spaulding Rehabilitation Hospital Director of SRH Quality and Compliance and Spaulding Rehabilitation Network Billing Compliance Officer provides strategic oversight of network-wide billing compliance program and operational direction of hospitals quality, patient safety, patient advocacy, risk, accreditation and regulatory and corporate compliance program.
Principal Duties and Responsibilities
1. Maintains current and accurate knowledge of regulations, laws, standards and industry developments pertaining to SRN related to billing compliance and educates network quality and compliance leaders.
2. Internal consultant to network and entity leaders for implementation of all matters of billing compliance and along with quality and compliance leaders assesses billing compliance risk and investigates billing compliance concerns.
3. Develops network-wide billing compliance policies and procedures.
4. Represents SRN at Partners Billing Compliance Meetings and other system meetings as appropriate.
5. Prepares and submits quarterly reports for PHS Audit and Compliance Committee
6. Maintains collaborative relationship with the MGPO/NSPG Physician Billing Compliance Officer and Partners Billing Compliance Manager to ensure coordination of efforts.
7. Plans, organizes and manages all quality, patient safety, patient advocacy, risk, accreditation and regulatory, billing and corporate compliance programs for SRH Quality and Compliance department.
8. Serves as SRH compliance officer. Responds to reports of compliance concerns, oversees local audits, and provides initial and ongoing compliance education. Meets with site CEO at least quarterly.
9. Chairs/co-chairs and develops agenda for quality, safety, and compliance committees and is a member of related SRH committees.
10. Administers safety event/incident reporting system. Investigates, reports and coordinates related corrective action for adverse events.
11. Administers patient satisfaction system and facilitates response to information.
12. Prepares quarterly and annual reports for SRH leadership, SRN leadership, governing body and regulators.
13. Maintains departmental budget.
Qualifications
1. Baccalaureate degree in health related field
2. Clinical experience required, e.g. registered nurse (preferred), PT, OT.
3. Masters Degree in relevant field desirable,
4. Proven project management skills.
5. 5 to 10 years experience in a complex healthcare environment with at least 3 years experience in a) compliance (billing preferred) and b) patient safety, quality management or performance improvement essential
Skills, Abilities, Competencies Required
1. Decision making and problem solving: able to take action in solving problems while exhibiting judgment and a realistic understanding of issues; able to use reason, even when dealing with emotional topics, review facts and weigh options.
2. Flexibility: able to remain open-minded and change opinions on the basis of new information; perform a wide variety of tasks and change focus quickly as demands change, manage transitions effectively from task to task; adapt to varying customer needs.
3. Leadership: able to assume a role of authority as necessary; advocate new ideas, even when risk is involved; set an example for coworkers; delegate responsibility and empower associates to make decisions; provide constructive feedback to others.
4. Planning, prioritizing and goal setting: able to prepare for emerging customer needs; manage multiple projects; determine project Qualifications:
Company Profile: Founded in 1971 as the Massachusetts Rehabilitation Hospital, Spaulding Rehabilitation Hospital Network is one of the largest rehabilitation facilities in the U.S., providing comprehensive rehabilitation treatment.
Our network includes:
* 296-bed main hospital * Over 60 physicians on staff * 7 specialized inpatient programs in rehabilitation * 4,000 inpatient admissions annually * 8 outpatient centers throughout Massachusetts * More than 200 physical, occupational, speech-language and recreational therapists * 140,000 annual outpatient visits. Spaulding Rehabilitation Hospital is the only rehabilitation hospital in New England continuously ranked since 1995 by U.S. News and World Report in its Best Hospitals survey.
Spaulding is an Equal Opportunity Employer. M/F/D/V
