PCM Evaluation Department- Quality Assurance and Assistant Scheduler

Tempus Unlimited Inc•Stoughton, MA

1d•Onsite

About The Position

This position supports the Personal Care Management (PCM) evaluation team with quality assurance and scheduling initial and re-evaluations. The primary role is to execute daily Quality Assurance (QA) workflows for MassHealth Personal Care Attendant (PCA) evaluations, verify system data accuracy, and maintain consumer records. This involves prioritizing appointments by date ranges, organizing by geography, and communicating with internal clinical staff (RNs and OTs), facilities, and consumers/surrogates. The role requires effective and efficient management of electronic calendar appointments and various forms of communication.

Requirements

Previous administrative support experience
Computer skills- MS Word, Excel
Good written and verbal skills
Strong organizational skills
Accuracy and attention to detail
Ability to multitask
Adaptability/flexibility
Self-motivated
Must be able to manage electronic calendar appointments, and various forms of communication effectively and efficiently.

Responsibilities

Perform mandatory daily audits of RN and OT digital folders to ensure all newly submitted MassHealth PCA evaluations are captured and processed immediately.
Verify and log evaluation receipt dates into the Zuke system daily.
Actively review paperwork for completeness; directly communicate with clinicians (RNs/OTs) if documentation is missing, incomplete, or requires corrections before submission.
Coordinate directly with the Prior Authorization (PA) department to formally communicate when audited evaluations are completely accurate and ready for final submission.
Assign initial evaluations to a Registered Nurse (RN)/Licensed Practical Nurse (LPN) and Occupational Therapist (OT) team.
Schedule Initial evaluations with consumer/surrogate.
Schedule re-evaluations as needed.
Outreach to those who are “On Hold” to stay up to date of their resumption of the program.
Enter evaluation time, date and location on initial calendar and duplicate info on each RN and OT personal schedule calendar.
Add re-evals to the calendar as needed.
Call consumer/surrogate daily to confirm evaluations scheduled for the next day.
Communicate with evaluation teams of any changes to their schedules due to cancellations etc., noting all changes on initial calendar for tracking, and add progress note in Zuke database.
Create Electronic folder for all initial evaluations with adding all required and applicable documents.
Create a Monthly Initial Calendar for evaluation scheduling after input of time off requests.
Duplicate info on all RN and OT calendars.
Create a Weekly Tracking Report of initial status for Department Manager.
Document a progress note for all calls, email, or other communication in Zuke.
Perform other duties as assigned.