Quality Improvement Specialist

POSITION OVERVIEW

Conducts regular monitoring and auditing to ensure the residential programs are in compliance with the organization's policies and procedures, the program guidelines, federal, state and local regulations for areas including but not limited to physical site, health and safety, financial, staff qualifications, provider monitoring and training. Reviews all documentation to assess the quality of care, adherence to company's mission and philosophy, and utilization of best practices. The Quality Management team serves as the primary contact between the organization, licensing agents, administrative entities and other team members including the persons supported and their representatives to ensure overall compliance needs are communicated to all relevant stakeholders

ESSENTIAL FUNCTIONS:

• The Quality Improvement Specialist will be responsible for the oversight of licensing and contractual compliance for their assigned region.
• Implements systems of audits and/or site inspections to ensure compliance with all applicable regulations, monitoring standards, and relevant statutes.
• Reviews medical documentation to ensure the medical needs of those supported are managed in a manner consistent with internal policy as well as county, state, and federal regulations and promotes the highest quality of care possible.
• Maintains the permanent chart of each person supported on their caseload to include EHR to ensure compliance with all applicable regulations and monitoring standard.
• Inspects residential sites to ensure the health and safety of the persons supported and staff as well as compliance with all regulations and monitoring standards.
• Conducts Licensing Instrument Inspections as scheduled and in accordance with regulation established timeframes.
• Conducts physical site audits for new referrals admissions within 7 days of move in date.
• Conducts reviews and audits of medical forms, COH, MARs, and fire drill checklists for accuracy.
• Audits the helpdesk requests identified as needing to be entered and the completion of the help desk tickets.
• Completes necessary additional audits and tasks for and in response to licensure surveys/inspections; prepares related reports and if necessary, plans of correction in consultation with Quality Management Manager.
• Reviews and analyzes program documentation to assess the quality of care, adherence to company's mission and philosophy, and utilization of best practices. Outcomes and trends will be reviewed with the Quality Management Manager.
• Tracks and monitors compliance trends identified through the audits and physical site inspections.
• Audits the documentation of the personal funds of the people supported within their assigned caseload to ensure proper financial management and compliance with all applicable laws and regulations.
• Perform other duties as assigned by the Quality Management Manager.

EDUCATION and/or EXPERIENCE:

Bachelor's Degree and two years' experience working in residential programs governed by regulations within the Department of Human Services; Associates Degree and four years' experience working in residential programs governed by regulations within the Department of Human Services; High School diploma and 6 years' experience working in residential programs governed by regulations within the Department of Human Services. Working knowledge of the Chapter 6400 and 6100 regulations preferred.

Other Requirements:

• Moderate local travel.
• Staff hired will be at least twenty-one years of age and will have received Acts 33 and Criminal clearances. All staff will be routinely screened for exclusion from participation in Federal Health Care Programs.
• Valid driver's license and current vehicle insurance and access to a vehicle.

• Maintain training compliance as defined in all pertinent regulations.
• Ability to comprehend access and utilize electronic medium and various computer programs.
• Ability to effectively present information, write reports and respond to questions from clients, families and staff.
• Ability to comprehend and apply basic mathematical concepts.

PHYSICAL DEMANDS:

While performing the duties of this job, the employee is frequently required to stand, walk, sit and talk or hear, use hands to finger, handle, or feel; reach with hands and arms; climb or balance; and taste or smell. The employee must occasionally lift and/or move up to 20 pounds. Primary environment: ambient room temperatures, lighting and traditional office equipment as found in a typical office environment.

All job requirements listed indicate the minimum level of knowledge, skills, and/or ability deemed necessary to perform the job proficiently. This job description is not to be construed as an exhaustive statement of duties, responsibilities, or requirements. Employees may be required to perform any job-related function as directed by their supervisor.