Regulatory and Quality Compliance Manager

Location: Greenwich, CT (In-Office Role)

Salary: $80,000 - $100,000/year

About the Role:

We are seeking a highly motivated and detail-oriented Regulatory and Quality Compliance Manager to join our team in Greenwich, CT. This role involves developing and implementing strategies for regulatory compliance, managing third-party payer authorizations, overseeing intake referrals, and ensuring quality standards are met within the organization. The ideal candidate will possess a strong understanding of Medicare regulations, experience in community-based home care, and a commitment to driving operational excellence.

Qualifications:

• Education: Bachelor’s degree required ; Master’s degree preferred.
• Experience: Minimum of 1+ years in community-based home care or related field required
• Familiarity with Medicare regulations and quality measures is essential.
• Experience with WellSky software is preferred

Essential Responsibilities:

• Develop and maintain policies, procedures, and training programs to ensure regulatory compliance.
• Design and implement strategies to meet regulatory and quality standards, including achieving 5-Star status.
• Oversee quality improvement activities, including KPI monitoring and performance tracking.
• Serve as the point person for regulatory compliance and anticipate emerging regulatory issues.
• Facilitate QAPI (Quality Assurance and Performance Improvement) committees and ensure timely reporting and action plans.
• Collaborate with department heads to address performance issues and implement corrective actions.
• Manage referral intake, schedules, and client outreach in coordination with the Nurse Manager and Client Care Manager.
• Monitor and follow up on documentation and maintain compliance with industry standards.
• Provide training and support for new hires and perform weekend/on-call duties as needed.

Key Skills and Abilities:

• Strong leadership and project management skills.
• Expertise in compliance with regulatory standards and Department of Public Health guidelines.
• Ability to integrate performance improvement with clinical and business operations.
• Proficiency in medical terminology and healthcare analytics.
• Exceptional communication, teamwork, and time management skills.
• Self-starter comfortable in a fast-paced environment with changing priorities.