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Date Posted09/29/2020
Job TitleQuality Improvement SpecialistCare Management Health Home
CityDix Hills
StateNew York
Enter a description of the Job

Description:

Do you want to make a difference in the lives of children and vulnerable persons? Do you want to help ensure their safety and well-being? Do you want to be part of a team that effectively works to improve the quality of care and quality of life of children, families, and vulnerable adults? Are you a person who is skilled with managing important details? Can you paint a relevant story to capture the interest of others, using data? Are you a people person with integrity who can form relationships either over the phone, via email or in person? If you are someone with a passionate interest in human services, who also possesses solid writing and computer skills, SCO wants you! Please see the attached job description for further details.

Specific Responsibilities:

1. Assist program staff to meet Federal, State and local code and regulations and accrediting body standards.

2. Perform Medicaid audits based upon written audit tools. This includes verification of each enrolled child and staff’s eligibility for the program and active Medicaid coverage.

3. Assist in Case Record Review activities and aggregating data, analyzing trends, and working collaboratively with program staff regarding follow-up activities and improvements, as required.

4. Develop, as needed, and/or utilize agency systems for on-going program data collection and trend analysis, implementing procedures to use such systems in areas such as: demographics, program specific demographics, etc.

5. Assist the Director of Quality Improvement with the formulation, implementation and monitoring of corrective actions to ensure program improvement including but not limited to: policy/procedure development and review, systems development and review, establishing benchmarks, personnel assignments, training, etc., tracking the implementation of corrective actions providing follow-up, as needed, with program staff.

6. Maintain up-to-date knowledge of the program regulations and any changes that occur in order to modify the Compliance Tests on an ongoing basis in order to ensure compliance with rules and regulations.

7. Ensure the implementation requirements, as indicated in the agency Quality Improvement manual.

8. Review Incident Reports as they are received and ensure timely submission to the Lead Health Home Collaborative for Children and Families (CCF) and the Department of Health (DOH) as necessary.

9. As a member of the Incident Review Committee, follow-up on those incidents, where there are gaps in information and request required documentation to prepare for presentation at Program Incident Review, which is held monthly.

10. As directed by the Director of Quality Improvement, participate in the collection of data to examine program wide issues, which impact on delivery of services including consumer surveys, chart reviews and outcome studies.

11. Assist in preparation for survey/audits by regulatory agencies.

12. As a member of the Quality Improvement Committee, identify problems for resolution through ongoing review and monitoring from such sources as risk occurrence, incident review, staff or client reports or interviews, meeting minutes, inspection results.
13. Prepare monthly and quarterly reports for submission to QI Director, such as: Consumer Safety, Internal Quality Monitoring, and Case Record Review. Also responsible for annual completion of consumer satisfaction survey.

14. Ensure SCO meets “Best Practice” standards of its accrediting bodies and oversight agencies

15. Demonstrate competency in external oversight agencies’ data and scoring methodologies, including NYS Department of Health, New York State Office of Mental Health (OMH) and NYC Administration for Children’s Services (ACS), Office of Persons with Developmental Disabilities (OPWDD).

16. Maintain a master list of all enrolled youth in the Care Management program.

17. Chair bi-monthly transfer and disenrollment program meetings.

18. Manage multiple electronic systems such as MAPP, UAS and an Electronic Health Record.

19. Perform all other duties as assigned.

Qualifications

Qualifications:

Bachelor’s degree required. Master’s degree preferred in Human Services, Social Work, Health Care Administration, Public Administration or similar field. One year’s experience in quality improvement/program evaluation and/or administration in not-for-profit settings, preferred.
Experience with computer database and word-processing programs such as MS-Office Suite–Word, Excel, Access–to create and maintain databases, track and analyze information and data, desirable.
Experience with audit preparation, accreditation/survey activities (especially COA), and Outcomes measurement is desirable.
Experience with Medicaid billing, ePACES, the Medicaid Analytical Patient Portal (MAPP), the Universal Assessment System (UAS) and the Child Adolescent Needs and Strengths (CANS-NY) assessment.
Experience with electronic health records.
Have a basic understanding of Care Management.

Company NameSCO Family of Services