Quality Review Specialist - Auditing

4C Health•Peru, IN

2d•$23 - $28•Onsite

About The Position

This position is responsible for coordinating and conducting all internal audits and assisting in preparation of external audits to ensure that the Center’s focus of quality client care is achieved. A person in this position will focus on the master audit plan of the Center. A person in this position must have an understanding of state and federal requirements including a clear understanding of Medicaid regulations. This position operates under minimal supervision and must exercise tact, judgment and confidentiality in contact with the public, clients and families, as well as fellow associates of the Center. Work is very broad in scope and requires a high level of professionalism.

Requirements

High School Diploma Required.
At least 1 (one) year of experience in the mental health field required.
Works well under supervision as well as independently.
Organizes/manages time and daily activities with little direct supervision.
Ability to think critically and analyze information/situations for most appropriate response.
Strong organizational skills and detail oriented.
Handles complex tasks and requests supervision when necessary.
Able to utilize databases and/or other electronic means to perform duties.
Models professionalism, teamwork and communication internally and externally.
Maintains positive working relations and rapport with the community.

Nice To Haves

Associates and/or Bachelors degree preferred.

Responsibilities

Demonstrate an understanding of state and federal regulations; including Medicaid.
Demonstrate the ability to complete audits within the agency as outlined in the master audit plan.
Demonstrate the ability to gather necessary information and present to the Lead Auditor.
Evaluate and assist in the development of audit tools and processes relating to quality across the Center.
Conduct internal Center audits including but not limited to GIRPP notes, OP charts, BPHC, DMHA (CAP), CANS/ANSA and/or risk assessments and others as identified.
Assist in the Center’s preparation for external audits (such as DMHA, BPHC/AMHHI, Payee, DCS, etc.) as requested by the Lead Auditor. This will include attending all Center audits to provide relevant documentation and information, track audit information on applicable spreadsheets, and assist the VP in reviewing and implementing CAP for all audits.
Identify concerns and develop a plan to address and correct areas of need with the assistance of the Lead Auditor.
Coordinate amendments to the Electronic Health Records (EHR) systems and processes.
Identify, attend and participate in trainings relative to position; internal and external.
Respond to client complaints; including contacting the client, investigating the complaint, contacting the supervisor and contacting the client with a resolution and/or close complaint.
Maintain positive internal customer relations and collaborate with those customers to implement continuous quality improvement techniques and philosophy.
Train newly hired Center associates as requested by the Lead Auditor.
Abide by all Center policies and procedures.
Maintain positive working relations and rapport with the communities served.