QA Specialist

Phoenix Group Home, LLC • Middletown, OH

2d • $30 - $32 • Hybrid

About The Position

This position provides quality assurance functions for programmatic operations. The Quality Assurance Specialist is responsible for auditing and reporting findings on paid claims, service documentation, and personnel/training records. This role also involves conducting internal investigations, researching and disseminating relevant rules and regulations, and providing training on compliance efforts to personnel. The position requires collaboration with the QA Manager to develop internal controls, promote best practices through technical assistance, and participate in agency meetings and committees. Additionally, the role involves other projects and duties as required by Operations.

Requirements

• Bachelor’s Degree and one year experience utilizing data to support the development of quality services.
• Excellent oral and written communication skills.
• Excellent time management skills.
• Excellent organizational skills.
• Computer skills (MS Office, MS Publisher, Excel, email).
• Valid Driver’s License.
• Reliable automobile with proof of current liability insurance.
• Acceptable driving record.
• Current vehicle registration and inspection.
• Clean criminal record.
• Basic mathematical skills.
• Ability to read, write and understand the language of the person served and read and write in English.
• Ability to work as a team member.
• Reliable transportation.
• Familiarity with Medicaid and OHMAS laws, regulations and standards.
• Human quality skills to advise, train and raise awareness amongst agency staff of the significance of business ethics and compliance.

Nice To Haves

• 5 or more years of experience in public mental health or developmental disabilities.
• 2 or more years of quality assurance experience.

Responsibilities

• Audit and report findings on a representative sample of paid claims and service documentation on a monthly basis.
• Audit and report findings on a representative sample of personnel and training records on quarterly basis.
• Conduct internal investigations.
• Research, compile and disseminate applicable rules, standards and regulations that are pertinent to the operations of the agency.
• Provide training on compliance efforts to personnel.
• Collaborate with the QA Manager to develop internal controls to detect and deter fraud, waste, and abuse.
• Promote best practice services by providing technical assistance to clinicians and administration.
• Participate in all agency required meetings or committees on a regular or as needed basis.
• Other projects and duties as required by Operations.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level