Overview

Conducts case file record reviews for compliance with regulations/company processes and identifies opportunities for improvement or corrective actions to ensure contractual performance expectations.

Responsibilities

• Conducts Site Reviews at locations as assigned and submit results.
• Participate in the Pre-Survey Review process.
• Review incident reporting and initiate follow up when needed.
• Participate in follow up with Corrective action plans (survey, audits, etc)
• Submit weekly QA reports in a timely manner to Quality Assurance Manager/Supervisor.
• Present feedback to management regarding areas that need improvement.
• Ensure all clients receive a return call within 24 hours of calling.
• Review quality assurance standards, studies existing policies and procedures and interviews personnel and patients to evaluate effectiveness of quality assurance programs.
• Implement and monitor standard operating procedures.
• Other duties as assigned.

Qualifications

• Associates degree in Human Services, education, psychology, sociology or related field required. Bachelor’s degree preferred.
• Minimum two plus years related experience
• Demonstrated knowledge of quality assurance procedures and federal, state and local coalition laws and mandates
• Demonstrated knowledge of computers and knowledge of data management processes
• Demonstrated knowledge of eligibility determination processes and filing procedures