Full Description

Benefits include

• • Family medical, dental, long term disability, 403(b) plan with 6% match, and more.
• • Generous paid time off policy.  (Annual accrual up to 208 hours - based on FTE status and available to use upon accrual).  Plus 11 paid holidays annually.

Schedule: Monday-Friday 8AM-5PM (occasional after hours for urgent need)

Overview

The Quality Assurance (QA) Coordinator assists Options to maintain a Quality Assurance System, which meets the conditions of the Coordinated Care Organizations (CCOs), State Contracts and Medicaid/Medicare. The QA Coordinator is responsible for facilitating communication between the Quality Assurance Team, the Internal Quality Assurance Committee, Options Management and Staff and/or other parties to coordinate quality management activities including, but not limited to, utilization review, chart compliance audits, employee education activities including peer reviews, fidelity and programmatic consultation and reviews, and contract adherence. This position also provides high level care coordination for hospitalized individuals, including state level hospitalized individuals, to ensure that services are connected upon discharge. The QA Coordinator works collaboratively with Options staff to oversee the CCO QA metrics. This position may include managerial level duties for designated departments or other specified staff.

Responsibilities

Works with the Chief Operations Officer and QA team to maintain a Quality Assurance Committee with Membership in alignment with CFRs, OARS and CCO Agreement standards.

Works with QA team and managers to follows annual compliance plan to ensure completion and that goals are met.

Raises system and compliance issues and follows until a resolution is complete. Maintains appropriate records of QA team activities and decisions.

Ensures that the CCO metrics are achieved. If necessary, provides the necessary mental health service to ensure metrics are met.

This position may be required to complete assessments and treatments plans (Children/Adults), meet clients in the community, and provide care coordination and transition planning for special cases.

Facilitates the development and adoption of standards (goals, objectives and benchmarks).

Coordinates the agency’s preparation efforts for reviews from oversight organizations.

Provides training and guidance to Options staff and subcontractors on Medicaid/Medicare compliance.

Works with electronic health record staff on workflows that meet compliance guidelines.

Provides assistance to fidelity or contracted programs as needed and may fill in to manage departments.