Administrative and Quality Assurance Manager

Human Services Administration Organization • Pittsburgh, PA

3d • Hybrid

About The Position

The Administrative and Quality Assurance Manager is responsible for overseeing administrative operations, regulatory compliance, and quality assurance processes across the organization. This role ensures accurate record management, supports audit readiness, maintains credentialing requirements, and manages key systems and staff to promote operational efficiency and compliance with applicable standards. This position reports directly to the Executive Director.

Requirements

• Bachelor’s degree in Healthcare Administration, Business Administration, or related field (or equivalent experience).
• 5+ years of experience in healthcare administration, quality assurance, or compliance.
• At least 2 years management or supervisory experience
• Knowledge of credentialing processes, audits, and regulatory requirements (e.g., FWA).
• Experience with Electronic Health Records (EHR/HRIS) systems administration.
• Strong organizational, analytical, and problem-solving skills.
• Act 33, Act 34, and FBI clearances (required upon hire).
• Valid Pennsylvania driver’s license and access to a personal vehicle with current insurance coverage.

Responsibilities

• Coordinate and fulfill individual client record requests in accordance with organizational policies and regulatory requirements.
• Maintain accurate, secure, and up-to-date records to ensure compliance with confidentiality and HIPPA standards.
• Facilitate and prepare documentation for Fraud, Waste, and Abuse (FWA) audits and Program Quality audits.
• Ensure timely and accurate submission of required materials to auditors and regulatory bodies.
• Support ongoing quality assurance initiatives and continuous improvement efforts.
• Develop, implement, and monitor quality assurance (QA) programs and initiatives.
• Ensure compliance with federal, state, and local regulations, as well as funding requirements.
• Conduct regular audits of case files, documentation, and service delivery.
• Prepare reports for leadership, funders, and regulatory agencies.
• Support accreditation and licensing processes as applicable.
• Collaborate with program managers to enhance service quality and client outcomes.
• Complete and submit managed care credentialing reassessments within required timeframes.
• Monitor credentialing requirements and maintain compliance with payer and regulatory standards.
• Serve as System Administrator for the HRIS/EHR system, including:
• Managing user access and permissions
• Maintaining system navigation structures
• Providing network support and troubleshooting
• Responsible for managing system upgrades to assess operational impact and implementation.
• Oversee the Finance Module, including invoicing, contract management, and billing processes.
• Oversee invoicing processes to ensure accuracy, timeliness, and compliance with contractual requirements.
• Prepare and monitor financial and operational reports as required by leadership and external stakeholders.
• Supervise Administrative Support staff and the operations Coordinator.
• Provide leadership, training, and performance management to ensure efficient administrative operations.
• Develop and implement workflow improvements to enhance productivity and service delivery.
• Monitor incidents and ensure proper reporting, follow-up and tracking data base.
• Maintain policies related to confidentiality, HIPAA and ethical standards.
• Address compliance issues and recommend solutions.

Benefits

• Competitive salary and benefits, including medical, dental, and vision insurance.
• Paid time off (PTO), holidays, and a retirement savings plan.
• Mileage and parking reimbursement for fieldwork.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager
• Number of Employees: 11-50 employees