Quality Assurance Program Supervisor (Behavioral Health)

Grafton Integrated Health Network•Winchester, VA

About The Position

Join us - and experience the deep fulfillment of knowing your work truly makes a difference! Be part of a team that leads with heart and grit, the Grafton way—where leadership, compassion, and dedication come together to change lives. The Quality Assurance (QA) Supervisor [https://recruiting.ultipro.com/GRA1018GRASC/JobBoard/73f75fb7-829c-44e6-9647-2d511efd4b34/?q=&o=postedDateDesc&w=&wc=&we=&wpst=] assures release of client information is performed in accordance with federal HIPAA requirements and that Grafton [https://www.grafton.org/]’s policies related to records management are implemented. They promote compliance with Medicaid requirements for DD Waiver services through active monitoring and auditing and by providing consultation and training to those who manage and deliver DD Waiver services. The QA Supervisor Elevates the organization’s use of critical root cause analysis (RCA) through conduct of RCAs following identified serious incidents.

Requirements

Requires a Associates degree in Business, organizational leadership, health information management, human services (related field)
2 years, records management, auditing/monitoring, data management, or supervision of operations

Responsibilities

Conducts monitoring and auditing activities to assure the completeness and integrity of client records. Provides direct feedback to users and managers on audit findings and assures identified errors are corrected.
Supports health information management (HIM)/records staff organization-wide through orientation, education, and sharing of relevant new or revised organizational and HIM practices.
Manages sensitive documentation releases such as those involved in potential or active legal matters. Serves as an organization-wide resource on compliance with the Health Information Portability and Accountability Act (HIPAA).
Conducts regular audits to assure documentation of Medicaid services is completed timely, accurately, and in compliance with Medicaid regulations. Reports audit findings to managers and serves as resource for clarification of requirements. Audit activities may involve the use of data from various sources such as the data warehouse or the organization’s video camera system.
Monitors actions taken in response to audit findings to assure required corrections are completed. Develops and provides related training, as needed, to assure a shared understanding of requirements by those providing services and their supervisors. Collaborates with the billing department to support accuracy in billing of these services.
Conducts Root Cause Analyses when data indicates a potential misunderstanding or lack of shared knowledge of a quality/compliance expectation or a potential error in a process related to complete and accurate documentation in clients’ records. Models the use of RCA techniques for others to promote the expansion of these activities.
Develops, as needed, specialized training related to HIM, quality assurance, and areas of compliance. Conducts and documents trainings in these areas. Training may be site, program, region, or organization-wide in scope.
Actively serves on organizational teams or committees, as assigned, such as the Corporate Compliance Committee. May serve in a QA or HIM role on workgroups or special projects to assure adherence to related regulations, quality assurance practices, and/or other applicable QA/compliance factors.
Actively utilizes the QA/Risk Management software system for tracking and monitoring serious incidents, corrective action plans, and stakeholder concerns. Enters information into this system in a manner that supports accuracy, validity, and completeness of data in a timely manner. Serves as a resource for other department staff in understanding and utilizing the system. Monitors related data reports and uses them to assure overall integrity of the system.
Generates data reports from the data warehouse, the QA/RM system, and/or through use of the video camera system to support the identification of trends and targeted areas for further review/improvement. Works closely with other department staff on these activities.
Collects supporting evidence to demonstrate compliance with regulatory and accreditation requirements and submits evidence to external parties as needed. Serves as active member of teams assigned to prepare for accreditation surveys, coordinating related activities, developing and providing related training, and actively participating during surveys.
Using the QA/RM system, supports program teams to assure ongoing compliance with corrective action plans and resolutions to stakeholder concerns. Generates related data reports and provides them to teams in a manner that best promotes meaningful use.
Serves as a lead or participant in periodic special projects, such as submission of required documents in support of new or atypical external reviews and monitoring activities such as Virginia’s Quality Record Reviews and Home and Community Based Services reviews.
Performs other duties as assigned.

Benefits

Medical, dental and vision
Flexible Spending & Health Savings Accounts
Generous Paid Time Off plan & attendance incentives
Employer Paid Life Insurance
Employee Assistance Program (EAP)
Short-term disability (STD)
Long-term disability (LTD)
Paid Career Development - we pay you while becoming certified in CPR, Ukeru [https://www.ukerusystems.com/], Mandt [https://www.mandtsystem.com/] and other career training!
401(k), including an employer match up to $2,500 annually
Education Assistance up to $5,250 annually
As Grafton is a 501(c)(3) non-profit, you may be eligible for federal student loan forgiveness