• Monitors documentation and processes to ensure the provision of quality services
• Helps new staff have a positive start
• Develops, coordinates and/or conducts trainings to ensure staff are well-prepared to perform their job
• Ensures compliance with all regulatory and oversight entities

This full-time Monday through Friday position coordinates program quality processes and program evaluation to ensure quality services are provided.  This position is responsible to monitor adherence to Medicaid and other regulatory and accreditation requirements and standards.  This position is also responsible for providing and/or coordinating required trainings for staff throughout the organization. 

Job Description: 

Objective: Coordinate quality assurance/ quality improvement processes and overall outcomes management.  Monitor adherence to Medicaid requirements for provision of quality services including individual plans, service provision, documentation, and billings. Monitor, recommend revisions and coordinate policies and procedures to comply with regulatory standards.  Provide and/or coordinate required trainings for staff throughout the organization. 

Duties:

• Treats everyone with dignity and respect. 

• Helps foster and maintain a positive and collaborative work environment. 

• Conducts audits of service plans, implementation, and documentation of services across agency programs. 

• Complete audits of service documentation and related billings to ensure compliance with Medicaid requirements. 

• Convenes Case Record Review, Program Quality Assessment and Quality Assurance meetings and prepares reports. 

• Coordinates overall program evaluation/outcomes management and quality assurance/quality improvement processes including compilation of data and preparation of related reports. 

• Coordinates collection of data required by funding sources and prepare related reports. 

• Assist in ensuring Administrative Manuals (policies and procedures) include all elements required for compliance with auditing and accrediting authorities. 

• Convenes ongoing Risk Management activities and generates written and oral reports to Leadership staff. 

• Monitor ongoing progress with electronic documentation system, including but not limited to, timely completion of all necessary documentation, reports, reviews and authorizations. 

• Monitor compliance with Carf standards and ensure readiness for Carf surveys.  

• Attend individual planning meetings periodically to assess quality of plan development and adherence to policies and individual rights. 

• Prepares quarterly compliance information with input by HDC Leadership staff. 

• Follows HIPAA, and confidentiality, and all other HDC policies and procedures and ensures compliance throughout the organization. 

• Ensures staff receive required and needed trainings to meet regulatory requirements, as well as needs of the organization.  Provides those trainings as needed. 

Performs other duties as assigned. 

Knowledge and Abilities: 

• Thorough knowledge of principles and techniques of providing quality, community-based services to individuals with disabilities 
• Thorough knowledge of federal and state regulations, policies, and procedures regarding services, and funding for individuals with disabilities 
• Thorough knowledge of Carf, HCBS waivers, and habilitation requirements 
• Ability to interpret laws, rules, regulations, policies and procedures 
• Ability to establish and maintain effective working relationships with individuals and groups at all levels of the o organization 
• Ability to evaluate situations and make correct decisions 
• Ability to express ideas effectively, orally and in writing 
• Ability to use computer to navigate and enter information into web-based software and perform basic functions related to computer use. (i.e. keyboarding, email, data entry) 

Training and Experience: 

• Graduation from an accredited four-year college preferably in the human services fields 
• Familiarity with operational and financial management, quality assurance, quality improvement, risk management and regulations 
• Experience in the field of disability services and regulatory entities’ requirements 

* Denotes essential functions of the position 

The statements herein are intended to describe the general nature and level of work being performed by employees assigned to this position. They are not intended to be construed, as an exhaustive list of all responsibilities, duties, and skills required of personnel so employed. 

Revised:  07/2022