Executive Upic Jobs (NOW HIRING)

Full Time Corporate Office, Troy, MI, US

Position: Director of Quality/Compliance Officer – Home Health & Hospice

Reports to: CEO/Administrator

Location: Hybrid position

Responsibilities:

• Lead agency-wide compliance and quality: oversee QA department, Quality Assurance & Performance Improvement (QAPI) initiatives, and Education/Training team.
• Ensure adherence to all Medicare home health/hospice regulations (OASIS/PDGM, hospice benefit, QRP) and accreditation standards (e.g., ACHC, CHAP if relevant).
• Manage all audits and surveys: plan for and respond to RAC/UPIC requests, state surveys, and internal reviews.
• Oversee OASIS and HOPE/HIS data quality: review trends, error rates, and implement corrective action plans.
• Develop, update, and enforce policies and procedures (Medicare CoPs, documentation requirements, compliance plans).
• Conduct regular compliance training for clinicians (OASIS training, documentation accuracy, HIPAA).
• Oversee Staff Orientation and education program: ensure staff continuing education, certification renewals, competency evaluations, and ongoing professional development in compliance with organizational and regulatory requirements.
• Monitor Medicare denials and appeals: work with billing and clinical staff to correct systemic issues.
• Collaborate with clinical leadership and the governing board on compliance strategy, reporting key metrics.

Qualifications (Must):

• Certifications: OASIS (COS-C or HCS-O) and coding (HCS-D or HCS-H or CPC/CCS).
• Experience: 5+ years in home health/hospice clinical or coding roles, with 2+ years in QA/compliance leadership.
• Medicare Knowledge: Deep understanding of PDGM, HH PPS, Hospice Medicare rules, and documentation standards.
• Licensed RN.
• Management: Experience supervising teams (QA, education, coders). Strong policy development and analytical skills.

Preferred (Nice to Have):

• Certifications: OASIS (COS-C or HCS-O) and coding (HCS-D or HCS-H or CPC/CCS).
• Compliance/Quality certifications (e.g. CHC, CHPC, CPHQ).
• Experience with HOPE implementation or Hospice Quality measures.
• Prior success leading multi-disciplinary committees.