Principal, Clinical Compliance, Quality Assurance and Training

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This role in the newly created Enterprise Integrity function is responsible for compliance, quality assurance and staff training across axialHealthcare’s suite of services. This role will be responsible for defining and building initial training for axial’s recovery partner, peer recovery specialist, clinical liaison, engagement specialist and clinical market lead roles. A successful program will define initial training for new hires as well as ongoing training for process improvement; include quality assurance audits and implementation of re-training with integrated audit results of their interactions into training and education; assist and develop training in biological and expand psychological assessment and management modules; develop and implement appropriate documentation process in care management modules; training across various systems such as Aunt Bertha and language modules; provide training in annual policies and regulatory updates and adjust policies to required client requirements and expectations. This individual will serve as part of the implementation team as needed to create a process for implementation to hand over to the operational team as they are hired and trained to the program.

Additionally, this person will assist in program and solution development, implementation, and quality assurance and improvement. They will research and provide guidance and development of materials related to solutions, especially related to respective areas of pharmacy, case and utilization management, take feedback and develop audit processes to assess program function and outcomes, and develop process improvements to meet or exceed required quality and financial outcomes. This individual will scan the health care environment for regulatory developing concerns and proactively work to address them within current solutions, assist in evaluations of competitive and environmental programs for opportunities and synergies with current solutions and/or development of supplemental or additional solutions for company use.  In addition, this individual will develop supervision protocols for current clinical staff and provide actual clinical oversight and/or recommendations. They will work as a liaison with client quality assurance partners to respond to grievances and complaints, and facilitate appropriate information for resolution of same.  Additionally, they will work with client quality departments to respond to quality audits and concerns, and develop appropriate responses and resolutions for same.

Responsibilities

  • Provide clinical training, oversight, and support to staff across both Risk Mitigation and Recovery Solutions.
  • Act in supervisory capacity during onboarding and training of Recovery related hires as market based teams are brought on board in preparation for program launch.
  • Scan the regulatory and federal requirements on a periodic basis to ensure keeping all our activity up to date and fully compliant
  • Management and updates of policy and procedures
  • Performance audits and review
  • Incident investigation for both the risk and recovery business lines
  • Assistance in the reporting metrics and clinical outcomes analysis for quality improvement of the business interventions and activities
  • Quality assurance and audit function, both internal and client based
  • Audits of activities performed by the staff and spot training/instruction

Requirements

  • Bachelor’s degree in healthcare related field with current, valid clinical license
  • Minimum of 5 years of experience in Clinical Compliance, Quality Assurance, or related field
  • Self-starter with start-up mentality to help build solutions, think critically, and adapt quickly
  • Experience developing and delivering training, ideally to clinical and non-clinical individuals
  • Ability to develop, maintain, and adapt policies and procedures for in-market staff
  • Previous experience performing audits and performance reviews
  •  Willingness and ability to travel for in-market training and prelaunch activity
  • Strong written, verbal, and in-person communication skills