Job Description

Job Summary
The Associate Director of Healthcare Compliance and Quality supports the Healthcare Compliance Director (HCD) in the development, implementation, and oversight of comprehensive compliance, quality assurance, and performance improvement programs across Pascua Yaqui Tribe Health Services Division (PYTHSD). This position ensures that PYTHSD's services meet applicable tribal, federal, and state regulations, including HIPAA, AHCCCS, CARF, and IHS requirements, while promoting safe, ethical, high-quality care and efficient documentation practices. The Associate Director works cross-functionally with department leaders and provides supervision to compliance and quality personnel.
Principle Duties and Responsibilities

• Assist in the development, implementation, and ongoing review of policies and procedures to meet healthcare compliance requirements.
• Monitor compliance with federal, state, and tribal regulations (e.g., HIPAA, AHCCCS, 340B, CARF, IHS) and respond to suspected non-compliance.
• Conduct or support internal audits and investigations, maintain documentation, and track follow-up actions.
• Oversee departmental preparation for audits and surveys, including CARF accreditation and AHCCCS Organizational Reviews.
• Conduct annual and regulatory trainings and maintain training records for all departments.
• Develop and implement quality improvement initiatives across all health programs.
• Chair Quality Improvement and Performance (QIP) Committee meetings and contribute to the development of performance metrics.
• Coordinate data collection and analysis related to service effectiveness, efficiency, client satisfaction, and clinical outcomes.
• Write and distribute annual Quality Management (QM) summaries and support submission of the annual QM/UM plan to AHCCCS.
• Collaborate with Third Party Billing to identify, document, and reduce revenue loss due to documentation deficiencies.
• Chair the Revenue Cycle Audit Committee and track deficiencies; recommend and oversee corrective actions.
• Investigate and document grievances, complaints, and appeals; ensure resolution in accordance with policy and regulatory requirements.
• Support policy and procedure development for future programs.
• Coordinate all documentation and preparations for licensure, CARF accreditation, and program expansion efforts.
• Assists in compliance aspects of new clinic development, including policy support and operational integration.
• Directly supervises compliance and quality support staff and other assigned personnel.
• Provides mentorship and training to staff on compliance and quality standards.
• Perform other duties of a similar nature or level as requested by the HCD.

Required Knowledge, Skills, and Abilities
Knowledge of:

• Complex federal, state, and tribal laws and regulations as they relate to behavioral and medical health;
• Strong understanding of healthcare regulations, compliance practices, and quality frameworks.
• Training requirements as dictated by CARF, AHCCCS and IHS requirements;
• CARF and AHCCCS Standards and Regulations;
• Supervisory management principles and practices;
• The PYTHSD and AHCCCS Grievance and Appeal process;
• Culturally competent and sensitive to the traditions of the Pascua Yaqui Tribe.

Skills and Abilities:

• Perform advanced mathematical/statistical calculations and data analysis;
• Read, analyze data, fiscal information, contracts and reports;
• Ability to manage multiple projects and deadlines with attention to detail.
• Computer use, including electronic health records, statistical and data base software programs;
• Establish and maintain effective working relationships with employees, other public agencies, and people from various socioeconomic backgrounds;
• Maintain confidentiality of information;

Education, Certifications and Experience Required

• Master's degree required in healthcare administration, compliance, or a related field.

• Preferred professional license (i.e., Registered Nurse, Pharmacist, Dietician, etc.)
• Five (5) years of Quality Management/Utilization Review or related experience.
• Certified in Healthcare Compliance (CHC) or Certified Professional in Healthcare Quality (CPHQ) required.

Special Requirements:

• Must possess and maintain a valid Arizona Driver's License.
• This position will require the incumbent to work non-traditional hours, nights ,and weekends;
• Must have a current Level 1 Arizona Clearance Card or be able to obtain the Level 1 Arizona Clearance Card within ninety (90) days of hire. Failure to maintain a current Level 1 Clearance Card will result in removal from this position.

The Pascua Yaqui Tribe provides 22 days of Paid Time Off which increases with years of service and 15 paid Holidays per year. We offer a comprehensive healthcare benefit package that surpasses or rivals the biggest organizations in Tucson. We encourage you to stay healthy by providing an onsite Wellness Center. Additionally, the Tribe offers a 401(k) Plan with a generous match in which you're immediately vested along with a profit sharing plan after one year of employment. Sworn police and and fire employees are eligible to make Pre-Tax and After-Tax contirbutions to the Arizona Public Safety Personnel Retirement Systems ("PSPRS").

Skills Required