The Director of Accreditation of the Community Health Accreditation Partner (CHAP) is responsible for daily operations related to all accreditation activities, as well as collaborating in the selection, training and evaluation of Site Visitors. The Director collaborates with other CHAP team members to ensure excellence in accreditation and customer service as well as CHAP continuous improvement. This person undertakes numerous oversight and supervisory activities in the pursuit of these goals including operational oversight and administrative activities to ensure consistent application of accreditation and regulatory standards, site visitor selection and retention, and the satisfaction and improvement of accredited organizations.
As a member of the organization’s management team, supports CHAP’s mission, vision, and goals to ensure CHAP is the preferred accreditor of home and community-based care providers and a thought leader.
Directs site visitor function including selection, training, supervision and evaluation. Conducts new hire orientation program and ongoing coaching as needed.
Reviews site visitor reports for accurate and consistent application of CHAP Standards of Excellence and regulations. Performs review and acceptance of Plans of Correction, communicating with organizations as necessary.
Provides training, direction and supervision to ensure proactive customer service from all department team members, to support CHAP growth and customer service goals. Ensures all team members follow CHAP Customer Service Standards.
Directs a team of site visitors remotely. Responds to telephone calls from site visitors to assist as needed through the visit process and decisions regarding application of CHAP and regulatory standards.
Plans for and executes Board of Review process with timely follow up of accreditation determinations and correspondence.
Participates in performance improvement and complaint investigation activities.
Responds to telephone and e-mails requests from pre-applicant and applicant organizations regarding selection of agency-specific service standards for accreditation and interpretation of CHAP Standards and CHAP’s process, standards, and self studies.
Serves as subject matter expert by maintain strong and current working knowledge of all CHAP standards and all Medicare and industry regulations pertaining to CHAP’s deemed status and accreditation programs.
Ensures complete and accurate documentation of actions in agency hard copy and electronic records, including customer relationship management software.
Collaborates with and assists other departments to ensure compliance with regulatory requirements and CHAP policies and to ensure CHAP accredited organizations improvement and satisfaction.
Assesses performance, identifies knowledge deficits, develops, and delivers teleconference and webinar training to site visitors at least quarterly. Responsible for in-services for site visitors and for helping site visitors with proficiencies in deficiency identification and documentation.
Assures appropriate projection of site visits days for production of contracts and review of self studies as well as site visits performed in accordance with CHAP timeliness standards.
Participates in strategic planning and reporting.
May participate in marketing and business development activity through attendance and presentations at trade shows and state association meetings.
Performs other duties related to the safe and efficient operation of the organization
This is a full-time position, based at CHAP’s District of Columbia home office
8 years' management experience including staff supervision
8 years experience in Medicare certified home health agencies and/or other community based health care services delivery
Strong knowledge of at least one of the following: Medicare Conditions of Participation for Home Health and Hospice, and Medicare Supplier/Quality standards
Experience in a CHAP accredited organization extremely helpful
Sound knowledge and skills in quality improvement activities and processes.
Excellent written and verbal communications skills; effective interpersonal and team building attributes. A strong communicator with the ability to communicate with a broad range of people, from providers to regulatory personnel.
High level of energy and focus on customer satisfaction.
Proficiency and a demonstrated competence in the Microsoft Office Suite an aptitude for technology and intermediate computer literacy
Demonstrated experience efficiently managing a professional staff, setting and maintaining clear and consistent standards for staff performance.
Proven consensus builder among diverse constituencies who is also an assertive decision maker.
Experience developing and managing strategic plans, implementing goals in an organized fashion.
Flexibility in work schedule. Some work-related travel required.
Internal Number: 1016
The Community Health Accreditation Program, Inc. (CHAP) is an independent, non-profit accrediting body. It was the first accrediting body for community-based health care organizations in the United States and was created in 1965 as a joint venture between the American Public Health Association (APHA) and the National League for Nursing (NLN). These organizations brought to fruition the futuristic view that accreditation was the needed mechanism for recognizing excellence in community health practice. In 1988, CHAP became a separately incorporated, non-profit subsidiary of the NLN under the CHAP name. In 2001, it was spun-off by the NLN and became an independent, non-profit corporation.
Because CHAP was granted "deeming authority" from the Centers for Medicare and Medicaid Services (CMS) for home health in 1992 and hospice in 1999, CHAP now has the regulatory authorization to survey agencies providing these services to determine whether they meet the Medicare Conditions of Participation (COPs). This marks a change from the previously used state surveys. In 2006, CMS granted CHAP full deeming authority for Home Medical Equipment (HME).