Quality Assurance Specialist/Certified Peer Support Specialist (48223)

WESTCARE INC•Pikeville, KY

22d•$20 - $20

About The Position

Person in this position will be responsible for assisting the agency in ensuring that documentation requirements for Medicaid, Medicare and other funding sources per chapter and contract guidelines are adhered to. Responsibilities include but are not limited to: clinical records review, medical records, staff training compliance, and interdepartmental communication. Person in this position is also responsible for providing peer leadership, outreach, advocacy, coaching and recovery support within the community. Essential Job Functions include: Essential Job Functions: Possess and/or develop expertise in the areas of quality documentation and records review in relation to Medicaid/Medicare regulations and all other federal, state and local rules and regulations that apply to WestCare Kentucky’s specific programs. Develop and/or utilize existing monitoring tools, forms, processes and implement systems for compliance in all programs which will ensure that the programs and individuals meet documentation requirements and clinical records through monitoring, education and training Conduct quality assurance site based reviews of client files Coordinate and facilitate ongoing trainings in relation to documentation fundamentals, staff onboarding, and other like trainings as assigned or. based on record review findings Manage and monitor WestCare Kentucky’s annual training plan and conduct staff training outstanding reports and follow up adherence measures. Possess and/or develop expert proficiency in WestCare Kentucky’s electronic health record; in the client file, service manager, and reporting features. Manage medical records; requests, distribution, ROIs, communication, etc. Attend staff meetings, training and in-service as assigned by supervisor and/or as required by the agency; Develop concise and timely reports, including reports by program regarding client file reviews, as necessary and distribute reports to the management team on a defined basis Serve as a positive role-model to individuals and their families, sharing experiential knowledge and skills. Works with individuals, families, and groups to provide outreach and emotional support. Educate and refer clients to community agencies and businesses that appropriately address their need for food, shelter, clothing, employment, transportation, social service benefits, etc. Provides warm hand off to community resources, services, and supports. Provide services that promote wellness, recovery, and resiliency. Assist clients with establishing or re-establishing support systems within their community. Engage with the family members of (or other persons significant to) those in crisis to educate them about self-care and ways to provide support Participate in clinical staffing decisions regarding the patients’ current strengths and resources and their need for additional resources. Engages individuals and families in crisis planning process using evidenced based practices including Motivational Interviewing and Mental Health First Aid. Facilitates stabilization and care coordination services post-acute intervention. Provides after hours services on a rotation schedule. Possess and/or develop expertise in the areas of quality documentation and records review in relation to Medicaid/Medicare regulations and all other federal, state and local rules and regulations that apply to WestCare Kentucky’s specific programs. Develop and/or utilize existing monitoring tools, forms, processes and implement systems for compliance in all programs which will ensure that the programs and individuals meet documentation requirements and clinical records through monitoring, education and training Conduct quality assurance site based reviews of client files Coordinate and facilitate ongoing trainings in relation to documentation fundamentals, staff onboarding, and other like trainings as assigned or. based on record review findings Manage and monitor WestCare Kentucky’s annual training plan and conduct staff training outstanding reports and follow up adherence measures. Possess and/or develop expert proficiency in WestCare ’s electronic health record; in the client file, service manager, and reporting features. Manage medical records; requests, distribution, ROIs, communication, etc. Attend staff meetings, training and in-service as assigned by supervisor and/or as required by the agency; Completes all orientation and mandated training activities, including E-Learning Courses, within required timeframes, and in accordance with the criteria established for this position. Must embrace and embody the mission, vision, guiding principles, clinical vision, and goals of WestCare Foundation; and Perform all other duties as assigned.

Requirements

Excellent communication skills.
Ability to exercise good judgment and discretion.
Ability to work well in a team environment.
Adherence to the highest standard of ethical conduct, especially to standards governing confidentiality.
Professional appearance and demeanor.
Must be sensitive to populations served.
Valid driver’s license and ability to obtain and maintain WestCare’s vehicle insurance is required.
During your tenure with WestCare there may be new requirements, including, but not limited to vaccinations that are issued by local, State, Federal, and/or Funders that WestCare may have to comply with. Should this occur Human Resources or appropriate personnel will inform you.
Two (2) years demonstrated recovery time from a significant mental health and/or substance abuse disorder at the date of application and within the last year either maintained at least 12 months of successful work or volunteer experience.
Familiarity with KY surrounding counties.
Ability to pass background clearance
Excellent language and interpersonal skills
Knowledge of HIPAA regulations and guidelines
Superior organizational skills and attention to detail
Strong computer skills, to encompass all Microsoft Office Platform Applications
Knowledge of electronic record keeping systems
A minimum of 40 hours per week are expected but additional hours may be required from time to time.
Regular attendance is required.

Nice To Haves

Training and/or experience in Crisis Intervention is preferred.
Bachelor’s degree from accredited institution with previous demonstrated QA experience in behavioral health field preferred
Certified Recover Peer Specialists or Certified Recovery Support Specialist obtained within one (1) year of hire; preference will be given to candidates who are currently certified.
Experience working with a substance abuse population is preferred

Responsibilities

Assisting the agency in ensuring that documentation requirements for Medicaid, Medicare and other funding sources per chapter and contract guidelines are adhered to
clinical records review
medical records
staff training compliance
interdepartmental communication
providing peer leadership, outreach, advocacy, coaching and recovery support within the community
Possess and/or develop expertise in the areas of quality documentation and records review in relation to Medicaid/Medicare regulations and all other federal, state and local rules and regulations that apply to WestCare Kentucky’s specific programs.
Develop and/or utilize existing monitoring tools, forms, processes and implement systems for compliance in all programs which will ensure that the programs and individuals meet documentation requirements and clinical records through monitoring, education and training
Conduct quality assurance site based reviews of client files
Coordinate and facilitate ongoing trainings in relation to documentation fundamentals, staff onboarding, and other like trainings as assigned or. based on record review findings
Manage and monitor WestCare Kentucky’s annual training plan and conduct staff training outstanding reports and follow up adherence measures.
Possess and/or develop expert proficiency in WestCare Kentucky’s electronic health record; in the client file, service manager, and reporting features.
Manage medical records; requests, distribution, ROIs, communication, etc.
Attend staff meetings, training and in-service as assigned by supervisor and/or as required by the agency
Develop concise and timely reports, including reports by program regarding client file reviews, as necessary and distribute reports to the management team on a defined basis
Serve as a positive role-model to individuals and their families, sharing experiential knowledge and skills.
Works with individuals, families, and groups to provide outreach and emotional support.
Educate and refer clients to community agencies and businesses that appropriately address their need for food, shelter, clothing, employment, transportation, social service benefits, etc.
Provides warm hand off to community resources, services, and supports.
Provide services that promote wellness, recovery, and resiliency.
Assist clients with establishing or re-establishing support systems within their community.
Engage with the family members of (or other persons significant to) those in crisis to educate them about self-care and ways to provide support
Participate in clinical staffing decisions regarding the patients’ current strengths and resources and their need for additional resources.
Engages individuals and families in crisis planning process using evidenced based practices including Motivational Interviewing and Mental Health First Aid.
Facilitates stabilization and care coordination services post-acute intervention.
Provides after hours services on a rotation schedule.
Completes all orientation and mandated training activities, including E-Learning Courses, within required timeframes, and in accordance with the criteria established for this position.
Must embrace and embody the mission, vision, guiding principles, clinical vision, and goals of WestCare Foundation
Perform all other duties as assigned.