QA Specialist
Quality Assurance Specialist
Summary
This is a professional and administrative position within the agency to coordinate and implement the quality assurance plan. The Quality Assurance Specialist is responsible for the quality of program deliverance in their identified area and ensure any identified needs are addressed accordingly in order to meet the standards of the agency. This position will work virtually but the applicant will need to be near one of our local service locations in Ocala/Tampa/Lakeland or Orlando. Please do not apply if not living in Central Florida as there may be times you will need to be physically in the office.
Essential Job Functions
- Review records for compliance with best practice, contracts, and Medicaid standards.
- Mentor new hires to ensure quality standards are met.
- Ensure Peer Reviews are completed timely and accurately.
- Report findings to management and ensure required follow-up is completed.
- Perform trainings as identified by quality assurance outcomes.
- Contribute to the development and implementation of Performance Improvement Plans for internal improvement.
- Prepare files and service centers for audits and site visits.
- Participate in the Risk Management program by identifying risk and addressing appropriately.
- Survey clients and caregivers for satisfaction and report outcomes to upper management.
- Work side by side with the clinical team and billing team for program development and improvement. This includes training, problem-solving, and support.
- Participate in the accreditation process.
- Regularly review reports to monitor trends with utilization management and compliance to ensure maximum benefit to the company.
- Participate in special quality assurance projects as needed.
Non-essential Job Functions
- Assist with support as needed which may include answering phones, faxing, etc.
Required Knowledge, Skills, and Abilities
- Clinical experience with progressive responsibilities for at least two (2) years.
- Strong understanding of Medicaid guidelines and funder expectations for service delivery.
- Experience in identifying programmatic needs and the ability to plan accordingly for improvement.
- Time management and task prioritization.
- Experience monitoring programs and service delivery and addressing areas for improvement.
- Must be able to work independently and be available during regular business hours.
- Must be able to travel as needed.
Educational and Work Requirements
- Masters degree in human services field preferred.
- Computer skills required to include Microsoft Excel, Word, and using electronic data systems.
- Strong knowledge of Medicaid guidelines for service delivery of Community Behavioral Health, Targeted Case Management, and Comprehensive Behavioral Health Assessments.
- Minimum of two years providing outpatient services to clients in a mental health or behavioral health area.
Other Skills/Abilities
- Ability to sit for extended periods of time and focus on assigned tasks.
- Able to work with and potentially lead a team to improve service delivery.
- Strong written and verbal communication skills.
- Must have a customer service approach and be able to deal with stakeholders assertively but respectfully when needed.
- Must work well as a team member and be able to successfully integrate ideas from all sources into regular work requirements.
- Excellent organizational and time management skills.
Families First of Florida participates in the eVerify program.