Quality and Compliance Administrator presso Ponca Tribe of Nebraska

Summary:

The Ponca Tribe of Nebraska is a federally recognized Tribe with its ancestral homeland located in Niobrara, NE. The Tribe does not have a reservation in the classic definition; rather, the Ponca Restoration Act defined its jurisdiction as a ‘Service Delivery Area’ comprised of 15 counties throughout parts of Nebraska, Iowa, and South Dakota. Within its Service Delivery Area, the Tribe offers a broad range of health, social, educational, and cultural services. 

The Quality & Compliance Administrator serves as the subject matter expert to coordinate the application of a quality management system by leading and monitoring the organization in Quality Assurance/Compliance and providing consultation to track Performance Improvement efforts. Incumbent is responsible to serve as the subject matter expert to ensure compliance with standards from accrediting organizations.

Essential Responsibilities and Duties:

1. Oversees the quality improvement/assurance program of the agency including application for accreditation, program reviews and compliance with all agency regulations, both federal and state.
2. Develop and oversee a plan, design, implement, and maintain a comprehensive medical practice continuous quality improvement (CQI) program including utilization management and risk management.
3. Assists in educating new staff, including physicians, about quality improvement (QI) systems and requirements.  In addition, adopt the best practices on population health measures with payers and meet quality outcomes for disease management such as diabetes, hypertension, etc.
4. Maintains written report on findings and activities of the Quality Improvement Committee
5. Work with grant programs under quality and compliance department to expand services with the members and clinic locations to assist in providing better outcomes for our patients.
6. Collaborates with department managers using KPI (key performance indicators) such as policy development, new technology, patient case study, and quality assurance monitors to prioritize staff development needs.  Including process management on proactive care with clinical departments across the organization to improve patient outcomes and utilization management.  These KPI dashboards will be prepared and distributed by the quality and compliance department for each provider, department, and organization as a whole.
7. Coordinates and performs/assists in clinic self-assessment audits of progress through the survey process.
8. Oversees the existing quality improvement program within the framework of objectives and policies established by AAAHC, CARF, and other certification agencies.
9. Assist in preparation for accreditation, surveys for accrediting, licensing bodies of all necessary entities.
10. Assist in performing audits and studies including the use of GPRA and diabetic indicators (SDPI)
11. Maintain an effective outcome driven quality improvement program.
12. Coordinate activities of the various departments within the agency to ensure compliance with all federal, state and local regulations as it relates to quality improvement and licensure.
13. Monitors unusual occurrences to establish trending or identify problem areas within departments Monitors clinical practice efforts to ensure compliance with internal and external QI standards.
14. Reviews medical records and other documentation to ensure quality care.
15. Prepare annual QI report.
16. Maintains quality performance category of revenue cycle enhancement such as Merit-based Incentive Payment system (MIPS) and, the Healthcare Effectiveness Data and Information Set (HEDIS).
17. Works with improving our referral care department to improve quality outcomes with other departments within Health Services.  In addition, the development of process improvement with incoming medical records for our Health Information and Privacy Officer for patient outcomes.
18. Assists in updating clinical manuals and procedural documents as required in a timely fashion.
19. Assists departments with preparation for program review by outside agencies.
20. Performs other duties, studies and research as deemed necessary by supervisors.
21. Provide training to staff on specialized topics as directed.
22. Meets deadlines for duties and assigned projects in a timely, efficient manner.
23. Contributes to the attainment of goals of the organization by promoting working relationships within the organization and contacts with individuals and agencies in the community in an effort to contribute to the better public understanding of health services for clinical departments, grant departments, and patient outcomes.
24. Learn and implement workflows within the electronic health records functions to work for the clinicians versus against the clinician for better outcomes and efficiencies.
25. Utilize staff within the department in a manner that will assist departments to become more efficient and patients to get comfortable with working across the organization.
26. Develop a Disney, Studer, and/or Chewy customer service experience for our patients, providers, staff and PTN members on a daily basis with becoming the Employer of Choice and Provider of Choice.
27. Other duties as assigned.

Relationships and Authority:

This position has supervisory responsibilities, but will work closely with the Chief Executive Officer, and leaders of Ponca Health Services.  Exercise balanced judgment in evaluating situations and making decisions

Working Environment and Physical Demands:

This position is in professional office environment. This role routinely uses standard office equipment such as computers, phones, printers, scanners, and photocopiers.  The employee must regularly be able to lift and/or move up to 25 pounds.  The ability to deal with time constraints and emotional stress and exposure to body fluids and viruses are also essential functions of this job

Qualifications:

Minimum:

Preferred:

1. Master’s degree in health administration or health-related field.
2. One year experience working with Native Americans or Native American organizations.
3. Knowledge and understanding of Public Law 93-638” Indian Self-Determination Act.

Preference will be given to Ponca Tribe of Nebraska members or members of a federally recognized tribe.  However, all qualified individuals are eligible.

The Ponca Tribe of Nebraska is an at-will employer.

Tribal Council Approval: 08/26/2025