Quality Assurance Associate
About The Position
The Quality Assurance Associate assists Options to maintain a Quality Assurance System which meets the conditions of the CCO, State Contracts and Medicaid/Medicare. The QA Associate works to facilitate communication between the Quality Assurance Team, Options Management and Staff and/or other parties to coordinate quality assurance activities. The Quality Assurance associate help to data gather and ensure Options is meeting its targeted bench marks associated with compliance. This position is detail oriented and requires data base tracking, reports writing and the ability to multi-task.
Requirements
- Degree or certification in a technical, health or business related field preferred.
- Excellent attention to detail and organizational ability, in order to set priorities, organize workload, handle multiple responsibilities, and meet deadlines from a variety of people.
- Candidates must be able to use e-mail, compose documents, save and locate documents electronically, and learn to use our Electronic Health Record (EHR) system.
- Possess business experience sufficient to meet the demands of the position, including demonstrated proficiency with a variety of software applications including MS Office, including Excel.
- Must pass state-required background and DMV checks.
- Candidate must be able to work independently and flexibly, under general supervision.
Nice To Haves
- Knowledge and understanding of the Medicaid/Insurance system a plus.
Responsibilities
- Works with the Quality Assurance team to gather data and provide appropriate reporting for the QA work plan.
- Provides data entry and other tracking responsibilities in multiple data systems.
- Reviews or assists with internal chart review process, compiles data and reports findings to quality assurance team. Communication with managers around chart audit findings and compiling completed documents.
- Works with outside subcontractors on authorizations and care coordination.
- Tracks incident reports and critical incidents.
- Provide initial UR authorizations, enter and track authorizations as indicated.
- Working with the assurance team to develop forms, review policies and procedures, maintaining agendas for and taking minutes for meetings.
- Prepares monthly activity reports, including but not limited to, reports on work plan activity, consumer survey results, agency feedback, complaint activity, credentialing, critical incidents, utilization review reports, chart compliance, access to services and dual diagnosis and special needs populations.
- Coordinates data collection and outlines timeframes/reporting requirements for contract deliverables.
- Communication with other agency teams, including management and executive team members.
- Candidate must be able to work independently and flexibly, under general supervision while maintaining a high degree of accuracy.
- Travels between sites.
Benefits
- Family medical, dental, long-term disability, 403(b) plan with 6% match, and more.
- Generous paid time off policy. (Annual accrual up to 208 hours - based on FTE status and available to use upon accrual). Plus, 11 paid holidays annually.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
Associate degree
