Quality Assurance Administrator
About The Position
The Columbus Organization is a group of caring professionals whose mission is to assist individuals at risk and with complex care needs remain in the least restrictive environment of their choice while improving their quality of life through coordinated services and supports. With a person-centered planning & thinking approach, it is our vision to be recognized as an organization that transforms individuals’ lives and provides families the peace of mind in knowing their loved one has a voice and a valued role in their community. The Quality Assurance Administrator (QAA) is responsible for overseeing, monitoring, and ensuring the quality of Case Management services in compliance with federal Medicaid regulations, state policies, and contractual requirements. This role ensures quality through auditing, data analysis, corrective action management, participant and family engagement, and continuous quality improvement initiatives. The QAA provides direct oversight of service documentation, performance audits, participant satisfaction efforts, complaint resolution, and the development and monitoring of corrective action plans. The QAA collaborates closely with program leadership, supervisors, and frontline teams to identify risks, address deficiencies, and strengthen overall service delivery.
Requirements
- Bachelor’s degree from an accredited institution in Human Services, Behavioral Sciences, Social Sciences, or a related field. In lieu of a degree, four (4) or more years of experience in a relevant field may be considered.
- Minimum of three (3) years of experience in quality assurance, compliance monitoring, auditing, or quality improvement within healthcare, Medicaid, HCBS, or developmental disabilities services.
- Knowledge of Medicaid, HCBS, and state policies and regulations.
- Strong analytical skills with the ability to identify trends and develop clear reports.
- Proficiency in Microsoft Office 365 and electronic record systems.
- Excellent written and verbal communication skills.
- Strong attention to detail, accountability, and ability to work independently.
- Ability to engage professionally with participants, families, and multidisciplinary teams.
- Strong organizational skills with the ability to prioritize and meet deadlines.
- Candidate must reside in Georgia.
Nice To Haves
- Experience in case management or developmental disabilities services strongly preferred.
- (Education or experience requirements may be waived where permitted by states based on demonstrated capability.)
- Experience developing and monitoring corrective action and quality improvement plans.
Responsibilities
- Oversee and implement the agency’s Quality Assurance and Continuous Quality Improvement (CQI) program for care coordination services.
- Conduct routine reviews of support plans and/or electronic case records using approved tools to verify completeness, documentation integrity, clinical appropriateness, and regulatory compliance.
- Coach Field Care Coordinators directly on documentation gaps.
- Submit finalized support plans to state agencies, in applicable markets.
- Monitor adherence to contractual deliverables, service timelines, and mandated documentation requirements.
- Analyze quality and performance data to identify trends, risks, deficiencies, training gaps, and areas for improvement.
- Prepare monthly, quarterly, and/or ad-hoc quality assurance reports, including required summaries to applicable states.
- Support state and federal audits, record reviews, and administrative monitoring activities.
- Monitor and evaluate the effectiveness of corrective action plans in response to audit findings, identified service deficiencies, and regulatory review outcomes.
- Partner with supervisors and leadership to strengthen service outcomes.
- Directly contact service recipients, families, and/or guardians when appropriate to follow up on identified quality concerns and confirm resolution, and promote participant rights and satisfaction.
- Oversee the complaint process, including intake, investigation, resolution, documentation, and trend analysis.
- Ensure participants are informed of complaint and grievance procedures in alignment with organizational, state and/or federal regulations.
- Identify needed improvements based on survey results and monitor implementation.
- Work in partnership with supervisors, program leadership, and training staff to support effective case management operations.
- Provide guidance and QA consultation to supervisors and leadership as needed.
- Participate in the review and revision of quality assurance processes annually or as needed.
- Communicate trends, risks, findings, and recommendations to leadership at least monthly.
- Assist with program oversight related to quality and staff competency.
- Participate in planning, implementation, and coordination to ensure alignment with federal, state, and organizational requirements.
- Maintain accurate QA documentation and records in accordance with confidentiality and HIPAA requirements.
- Complete all required annual and assigned training.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
