Quality Management Specialist (61511)

ARISE CHILD AND FAMILY SERVICE INCCity of Syracuse, NY
$25 - $26Onsite

About The Position

Indera is looking for a Quality Management Specialist to assist with the Serious Reportable Incident (SRI) process, ensuring compliance and timely submission of documentation. This role involves tracking SRI information for trend analysis, performing internal file reviews and waiver provider service audits across an 8-county region. The specialist will also develop and implement corrective action plans, manage annual participant satisfaction surveys, and assist with reviewing Service Plans and provider applications. Additionally, the role requires developing and submitting various reports to the DOH, making policy recommendations, and upholding professional conduct and confidentiality. The position operates within a safe office environment.

Requirements

  • Proficient computer skills, especially with Microsoft Suite; demonstrated ability to learn new computer systems and software
  • Excellent interpersonal skills both in person as well as on the phone
  • Demonstrated professional verbal and written communication skills; ability to gather important information from individuals and share/capture in a variety of methods; excellent ability to present information to a variety of audiences
  • Strong organizational skills with physical and electronic records and data
  • Working knowledge of: community-based resources and services, operation of 1915 (c) waivers, issues concerning individuals with disabilities and seniors, and benefits provided by Medicaid, Medicare and/or other third party payers
  • Clean Driver License and inspected, insured, reliable transportation
  • Experience in person centered planning and team building
  • Ability to review and analyze records, reports and surveys in order to determine trends
  • Proven ability to assist program development
  • Possess a Bachelor’s degree in health or human services or a related field and two years of combined satisfactory professional experience in working with individuals with disabilities and/or seniors
  • OR Be a Registered Professional Nurse and have one year of combined satisfactory professional experience working with individuals with disabilities and/or seniors, including in a managerial capacity
  • OR Possess an associate degree and five years of combined satisfactory experience working with individuals with disabilities and/or seniors, including in a managerial capacity

Responsibilities

  • Assist with Serious Reportable Incident process, assuring compliance and the timely completion and submission of all required documentation associated with investigatory process both internally with the RRDC and with the waiver providers across an 8-county region
  • Track all pertinent information pertaining to SRIs for analysis to identify any regional trends and emerging issues
  • Perform internal DOH RRDC file reviews of a sample of participant records quarterly and confirm adherence to proper authorization procedures and satisfaction of waiver requirements
  • Perform waiver provider service audits across an 8-county region with 40 plus providers
  • Perform trend analysis identifying problematic areas across an 8-county region, and develop activities/trainings that will support positive outcomes
  • Develop, implement, and ensure completion of plan(s) of corrective actions
  • Ensure waiver participants complete annual participant satisfaction surveys using the DOH designated form to assess participant satisfaction with NHTD/TBI waivers and to monitor quality assurance activities
  • Assist RRDS in reviewing Service Plans upon request to ensure information is accurate and meets the health and welfare needs of the participant
  • Assist with provider enrollment process and submission to DOH
  • Review quarterly and annual SRI reports from the waiver providers
  • Submit a monthly numbers report for the NHTD/TBI to DOH waiver staff
  • Submit quarterly SRI reports for NHTD/TBI to DOH waiver staff
  • Submit quarterly complaint reports for NHTD/TBI to DOH waiver staff
  • Make recommendations to the Lead RRDS/DOH based on experience for improvements to NHTD/TBI waiver policies and procedures
  • Uphold the codes of conduct and ethics as well as all Indera policies and procedures
  • Exercise sound judgment as a matter of course and hold protected health information and other sensitive information in the strictest of confidence in accordance with ARISE and HIPAA policies
  • Other duties as assigned
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