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As part of a multidisciplinary Older Adult Programs team, the Quality Assurance Manager is responsible for the areas of Contract Compliance, Utilization Management, and Quality Assurance. This includes the development, implementation and oversight of quality assurance and improvement functions for agency contracts and grants for Holocaust Survivor Services, MSSP, and ALW programs.
Qualifications
- Master’s Degree required. MA in social sciences field preferred.
- 2 + years quality assurance experience strongly preferred.
- Progressive management experience highly desired.
- Program operations and contract compliance experience strongly preferred.
- Sound clinical skills and understanding of clinical terminology.
- Solid proficiency in computer skills (Microsoft suite; Word, Excel, etc.) and ability to quickly learn and train others on electronic health record database systems required.
- Strong organizational, assessment, decision-making, problem-solving and time management skills.
- Excellent communication (written and verbal) and interpersonal skills. Ability to articulate and professionally communicate with staff and other stakeholders including grantors and regulatory agencies.
- Solid training skills and ability to impart information to staff both in one-on-one and group settings.
- High degree of detail orientation and analytical thinking required.
- Knowledge of CARF, Joint Commission, state standards or other accreditation bodies and criteria a plus.
- Ability to work as part of a team and maintain professional boundaries.
- Demonstrated ability to work independently, set priorities and complete projects within specified timeframes.
- Culturally sensitive and able to work with a multicultural client/customer population.
- Able to work under pressure and meet deadlines as well as be flexible and dependable.
- Must be able to pass criminal background check (Live Scan fingerprinting) prior to beginning employment.
Responsibilities/Essential Functions:
Contract Compliance
- Manage all aspects of contract compliance for Older Adults Programs which include: Claims Conference, MSSP and ALW contracts.
- Provide daily direction and supervisory oversight to Program Coordinator of Holocaust Survivors Program.
- Create new systems for assessment, tracking and monitoring as needed. Compile reports and maintain program statistics for funding sources and regulatory agencies.
- Prepare internal and external grant reports monthly and as required to monitor compliance.
- Liaison with outside agencies, community members and regulatory agencies as needed.
- Train staff members on contract requirements affecting program implementation and compliance issues.
- Monitor, keep updated and communicate effectively and efficiently on any upcoming or immediate modifications to contracts. Implement staff meetings/other methods of communication as needed to update/train staff on changes affecting daily program operations, protocols, and service delivery.
- In conjunction with program directors, create and maintain updated protocols and procedures for service delivery and contract compliance.
- Identify areas to increase efficiency, effectiveness of current systems relative to contract compliance and utilization management and controls.
Utilization Management
- Work with management team to maintain efficient and effective delivery of quality services.
- Assist program directors in monitoring of budgets and timelines as needed for implementation of services.
- Implement monitoring methods to evaluate effectiveness of services and collaborate with managers and directors to develop utilization management policies including documentation and client management.
- Organize and lead the Quality Assurance Utilization Review meetings established as required by contractual agreement or funding source requirements.
- Coordinate efforts with Program Directors to mitigate barriers that negatively affect the service delivery and contract utilization.
- Identify and implement ways to improve utilization of services to fully meet budget/contract goals.
- Maintain adherence to changes in laws and contract regulations.
Quality Assurance
- Implement efficient and user-friendly system of service data tracking, contract utilization through use of electronic health record or other program specific database platforms.
- Create quality assurance and improvement plans using established protocols, and as required by contract or funding source agreement.
- Primary responsibility for QA/QI functions including case/record reviews, collaboration with program directors on coordination and tracking of case assignments and documentation. Review charts for accuracy and completeness. Assure accuracy of billing prior to submission. Organize and lead quality assurance utilization review meetings as required by funder or by agency accreditation body.
- Consistent and regular analysis of program data and utilization of contract funding that support impactful program outcomes.
- Prepare charts for internal and external agency audits.
- Attend funder meetings as appropriate.
Other
- Perform all other duties as assigned.
Jewish Family Service is proud to provide equal employment opportunities to all employees and qualified applicants without regard to race, color, religion, sex, sexual orientation, national or ethnic origin, age, disability or status as a veteran.