SUMMARY

The Quality, Risk and Compliance teams focus on maintaining compliance and auditing to mitigate risk for our operations. This keeps the company in compliance with State, Federal and overall company requirements, but most importantly to keep our clients safe and help them live their best life.

ESSENTIAL JOB FUNCTIONS

To perform this job successfully, an individual must be able to satisfactorily perform each essential function listed below.

Conduct case file and record reviews for compliance and identifies opportunities for improvement or corrective actions and to ensure contractual performance expectations are met.

Submit weekly Quality Assurance reports in a timely manner

Present consistent feedback to management regarding areas that need improvement

Ensure 100% of clients participate in the client satisfaction survey

Ensure all clients receive a return call within 24 hours of calling and leaving a message

Review quality assurance standards, study existing policies and procedures and interviews personnel and patients to evaluate effectiveness of quality assurance programs Creates, implements and monitors standard operating procedures

Performs other related duties and activities as required

SUPERVISORY RESPONSIBILITIES

• None

Minimum Knowledge and Skills required for the Job

The requirements listed below are representative of the knowledge, skill, and/or abilities required to perform the job.

Education and Experience:

• Associates degree in Human Services, education, psychology, sociology or related field required, Bachelor’s degree preferred
• Minimum two plus years related experience

Certificates, Licenses, and Registrations:

• Valid driver’s license from state of residence

Other Requirements:

• Demonstrate knowledge of quality assurance procedures and federal, state and local coalition laws and mandates
• Demonstrate knowledge of computers and knowledge of data management processes
• Demonstrate knowledge of eligibility determination processes and filing procedures
• Travel 0-25%

Physical Requirements:

• Light work. Exerting up to 20 pounds of force occasionally, and/or up to 10 pounds of force frequently, and/or a negligible amount of force constantly to move objects. If the use of arm and/or leg controls requires exertion of forces greater than that for sedentary work and the worker sits most of the time, the job is rated for light work.