Description
The Quality Assurance and Quality Improvement (QA/QI) Specialist will ensure quality monitoring and improvement, program evaluation tasks, and agency planning processes.
This is a professional level exempt position reporting to the Deputy Executive Director of Community Support Services. The QA/QI Specialist performs in accordance with professional ethics and established policies. They are expected to function with substantial initiative as well as utilize independent judgement.
Job Duties
Works to ensure agency compliance (to include licensure reviews) with the Department of Behavioral Health and Developmental Services (DBHDS), the Department of Medical Assistance Services (DMAS), the Office of Human Rights, Library of Virginia, and agency policies and regulations.
Collaborates with Program Managers/Directors to write and/or advise in the development and revision of Individualized Support Plans (ISPs) to ensure the provision of high quality individualized services consistent with the needs and preferences of the individuals receiving those services.
Ensures that all individual records are current and complete as well as in compliance with state regulations and agency policies. Facilitates on-going assessments of documentation requirements throughout the agency to ensure that requirements are met utilizing the most efficient process possible.
Reviews and approves all ISPs.
Completes necessary reports using DBHDS’ Computerized Human Rights Information System (CHRIS) as well as attending to service authorizations through the Waiver Management System (WaMS) on a needed basis.
Reviews service dates for the reimbursement billing process.
Provides administrative guidance and sets up controls for the regular review of individual records and the systematic collection and posting of data. Prepares periodic reports, including Individual Support Plans according to organizational procedures and regulatory compliance statutes. Ensures maintenance of individual records.
Develops and implements initiatives as recommended by the Quality Assurance Committee while acting as a key member of the QA committee.
Conducts Human Rights agency investigations as needed.
Maintains close liaisons with agency administration and service delivery site as well as a professional liaison with designated oversight agencies.
Serves as records retention officer to verify the retention and deposition of agency records in accordance to the Library of Virginia regulations.
Provides scheduled and unscheduled compliance reviews of all programs.
Works cooperatively with Program Managers and Directors on areas of agency compliance and utilization review of quality assurance standards including serving as an agency resource to staff in the development and implementation of corrective activities.
Provides status reports to the Deputy Executive Director of Community Support Services and record evaluation reports for agency management.
Delivers documentation training of new hired staff with a particular focus on quality of service and compliance terminology, tasks, and outcomes as they pertain to the greater context of the agency’s mission (i.e. the importance of documentation, the standards of documentation, how that interrelates with reimbursements for services, auditing, etc.)
Performs other job related duties as assigned by the Deputy Executive Director of Community Support Services.
Skills Required
Knowledge of: developmental disability support systems, person-centered planning, community integration, service coordination, and governmental regulations as they pertain to services for individuals with developmental disabilities; principle of quality assurance, risk management, and performance improvement techniques.
In addition: knowledge of incident reporting, assessments, and service authorization processes, as well as knowledge of DBHDS licensing regulation, Human Rights regulations and HCBS regulations.
Skills: strong organizational skills, effective monitoring of CHRIS and WaMS
Ability: to interact well with staff as well as outside agencies and resources, to develop and implement guidelines, protocols, and best practices.
SUGGESTED TRAINING AND EXPERIENCE:
Bachelor’s Degree in a human services related field with three years of experience or a combination of education, training, and experience providing the required knowledge, skills, and abilities.