Quality Assurance Manager - Personal Care Services Division

Addus HomeCare•Frisco, TX

3d•Remote

About The Position

POSITION SUMMARY : Reporting to the Vice President of Quality Assurance, the Regional Quality Assurance Manager is responsible for facilitating and assuring in home care service provision is compliant with applicable Medicaid, Medicaid waiver, MCO, and other licensure and contractual requirements throughout Michigan, Ohio, Delaware, Pennsylvania and Tennessee. >> We offer our team the best << Medical, Dental and Vision Benefits Continued Education PTO Plan Retirement Planning Life Insurance Employee discounts Company matched 401K ESSENTIAL DUTIES : Develop, review, revise and implement standardized state specific policies, procedures and work processes that comply with Medicaid and other regulatory/contractual payer agreements Educate branch leadership and staff on state regulatory and contract requirements. Perform on-site and desktop audits and monitoring to assess branch level compliance with applicable rules and regulations. Oversee and support external agency audit processes including audit preparation, deficiency remediation and corrective action planning. Monitor corrective action execution and drive accountability. Drive operational compliance and quality outcomes. Report internal and external audit findings at all levels including branch, regional and senior leadership. Facilitate investigation, reporting and resolution of critical incidents and complaints. Investigate requests for recoupments by reviewing records and documentation. Performs other duties as assigned PERFORMANCE RESPONSIBILITIES: Maintain positive internal and external customer service relationships Maintains open lines of communication Plans and organizes work effectively and ensures its completion Meets all productivity requirements Demonstrates team behavior and promotes a team-oriented environment Actively participates in Continuous Quality Improvement Represents the organization professionally at all times

Requirements

Bachelors Degree in Business, Social Services, Public Administration, Nursing or a related field of study
3 5 years of experience in health care, social services or a related industry
Must possess strong communication, written, interpersonal and organizational skills
Proficiency in using Microsoft Word, Excel, PowerPoint and Outlook, required.
Ability to travel up to 75%.
Position may work remotely.
Must be self-confident, thorough, and prompt in completing assignments and projects
Passionate, energetic, tenacious and resolute, with a high sense of urgency and a strong drive to produce results
Valid Drivers License

Nice To Haves

Audit experience is preferred
Some experience in a large, fast-paced, results-driven, multi-site organization

Responsibilities

Develop, review, revise and implement standardized state specific policies, procedures and work processes that comply with Medicaid and other regulatory/contractual payer agreements
Educate branch leadership and staff on state regulatory and contract requirements.
Perform on-site and desktop audits and monitoring to assess branch level compliance with applicable rules and regulations.
Oversee and support external agency audit processes including audit preparation, deficiency remediation and corrective action planning.
Monitor corrective action execution and drive accountability.
Drive operational compliance and quality outcomes.
Report internal and external audit findings at all levels including branch, regional and senior leadership.
Facilitate investigation, reporting and resolution of critical incidents and complaints.
Investigate requests for recoupments by reviewing records and documentation.
Performs other duties as assigned
Maintain positive internal and external customer service relationships
Maintains open lines of communication
Plans and organizes work effectively and ensures its completion
Meets all productivity requirements
Demonstrates team behavior and promotes a team-oriented environment
Actively participates in Continuous Quality Improvement
Represents the organization professionally at all times