Director of Quality and Compliance – Healthcare

🕒 Outubro 27

🇺🇸 Estados Unidos – Remoto (EUA)

💵 $135.000 - $155.000 / ano

⏰ Tempo Integral

🔴 Especialista

🚔 Conformidade

👻 Score fantasma 10%

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• Aberta há 14 dias.
• As vagas desta empresa costumam ser preenchidas em 25 dias.

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Holon Health

SiteLinkedInTodas as Vagas

2 - 10 funcionários

Fundada em 2023

🏥 Saúde

☁️ SaaS

💰 $200.000 Pre seed em 2023-11

Healthcare • SaaS

Holon Health é uma provedora de saúde focada em cuidados acessíveis e de baixo custo ou gratuitos, além de oferecer suporte à recuperação para pessoas que vivem com transtornos por uso de substâncias e preocupações relacionadas à saúde mental. Eles oferecem atendimento primário, consultas por telemedicina, prescrições, coaching entre pares e de recuperação, além de suporte 24/7 por meio do aplicativo Holon Vibe, que também utiliza recompensas de gerenciamento de contingência para engajamento. A Holon atende clientes diretamente e faz parcerias com tribunais, organizações comunitárias, planos de saúde e prestadores; seus serviços são cobertos pelo Medicaid, Medicare e pela maioria dos planos de mercado.

Descrição

• Own all SOPs, state and health plan addenda, annual reviews, updates, and document control • Define compliance requirements, regulatory or contractual sources, and acceptance criteria for platform controls • Receive, triage, review, and manage incidents, accidents, deaths, and suspected abuse, neglect, or exploitation • Determine reportability and file external reports within applicable deadlines • Track follow-up reports, returned reports, confirmations, and closure • Escalate sentinel events and deaths to the Medical Director and CEO • Maintain incident rules tables and abuse hotline directories with approved change control • Ensure mandated reporter obligations are met and documented • Lead root cause analyses and corrective and preventive action plans • Present corrective actions to the HEQMC and track verified completion • Plan and run internal audits of clinical, billing, CoCM, RTM, consent, and telehealth documentation • Report audit findings, root causes, and corrective actions; track closure and re-audit • Coordinate pre-bill review findings and overpayment refunds with revenue cycle • Partner on SOP training, competency checks, staff briefings, and training records • Coordinate technology dependencies and interim operational controls with Product Development • Prepare responses to payer quality-of-care inquiries, audits, record requests, and corrective action requests • Monitor state Medicaid, health plan, CMS, privacy, and contract changes • Maintain state and health plan reporting portal accounts • Serve as HEQMC secretariat and prepare agendas, minutes, action logs, SOP approvals, and quarterly quality packs • Report quality and compliance metrics to the HEQMC and CEO • Support NCQA Health Equity Accreditation readiness and accreditation work

🎯 Requisitos

• Clinical license (for example RN, LCSW, LPC); or bachelor’s degree in a health-related field; or bachelor’s degree in business, operations management, industrial engineering, or related field; or equivalent formal training in operations management, process improvement, or quality management • 7+ years of experience in healthcare quality, compliance, risk management, accreditation, operations management, or process improvement and quality management • Multistate compliance experience • Experience with regulatory reporting and compliance • Experience with incident or event management, root cause analyses, and corrective action plans • Experience writing and maintaining SOPs and training staff • Strong writing skills • Working knowledge of HIPAA Privacy and Security Rules and 42 CFR Part 2 • Comfort working in EHR or app-based workflows, dashboards, and spreadsheets • Healthcare quality, compliance, risk management, accreditation, operations management, or process improvement experience • Bonus: CHC, CPHQ, Lean Six Sigma Green Belt or higher, ASQ CQIA/CQE, mandated reporter duties, telehealth, behavioral health, integrated primary care, Collaborative Care, state Medicaid, NCQA accreditation, CoCM/RTM documentation and billing, health equity data stratification, or a master’s degree

🏖️ Benefícios

• Annual leadership bonus • Unlimited PTO • Flexible schedules • Remote-first culture • Health, dental, vision, life, and disability benefits • 401(k) with company match • Space for self-care • Room to grow in a high-impact, mission-driven startup • Equal opportunity employer

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