New York, New York
The QAS is responsible for the overall quality assurance activities of the Medicaid funded Health Home Care Management program. The responsibilities include continuous chart review and retrospective billing reviews; delivering results and feedback to staff and supervisors, identifying trends, creating and facilitating training, monitoring quality improvement projects, and creating and providing various weekly and monthly reports. This is a critical analytical role that requires interfacing with staff at all levels, including internal and external stakeholders. This is an in office position with potential of remote work.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
1. Review client billing files (HMLs) using internal tools to ensure monthly billing can be substantiated by documentation in client files (including verification of diagnosis); work with Care Manager Supervisors and Directors to ensure remediation plan for deficient charts is in place; review charts after implementation of plan.
2. Review client charts using Lead Health Home audit tools as well as internal tools to ensure assessments are filled out comprehensively and completely, care plans map to assessments and include SMART goals, and progress notes relate to care plans and chart client’s ongoing movement through the Health Home program.
2. Work with program staff to prepare for internal and external audits;
3. Identify and provide insight into trends found in charts and documentation to provide staff with the necessary tools, trainings and guidance to ensure quality care coordination;
4. Explore areas for improvement based on collected data and work with the management team to identify and implement potential solutions;
5. Create & utilize spreadsheets, quality management tools and reports, and graphs to communicate data;
6. Generate and update reports using electronic health record, external, and internal databases to gather, synthesize, and convey information effectively and in a meaningful manner;
7. Assist with on-going training of Care Management staff using data driven reports and analysis;
8. Communicate and collaborate with supervisors and management team to consistently inform them of key findings and trends;
9. Design, Implement, and Manage Quality Improvement projects with the support of the Health Home management team and the internal Quality Improvement Department;
10. Perform other duties and participates in special projects as directed by the VP of Integrated Health and Operations.
11. Participate in QA/QI activities and designated/required program and staff meetings, including internal and external trainings.
12. Perform other duties as assigned.
MINIMUM EDUCATION/EXPERIENCE REQUIREMENTS: 1. Master’s degree in a relevant field with a minimum of one years’ experience in quality management, or quality improvement required. 2. Good oral and written communication skills, as well as good interpersonal and the ability to effectively work as part of a team. 3. Demonstrated computer proficiency, particularly with Microsoft Office (Word, Excel) and electronic health record systems. 4. Demonstrated knowledge of HIV/AIDS, chronic medical conditions, mental illness, substance use, and homelessness, as well as a basic understanding of public benefits and entitlements. 5. Good organizational and time management skills and demonstrated ability to problem-solve using good judgment in a complex social and health services environment. 6. Strong analytical skills centered around collecting, organizing, and disseminating information with the ability to analyze and interpret various forms of data. 7. The ability to work effectively with people from diverse cultures and socioeconomic backgrounds.
PHYSICAL DEMANDS/WORKING CONDITIONS: • Must be able to remain in a stationary position 50% of time. Frequently move about inside the office to access file cabinets, office equipment, meet with clients and supervisor or co-workers, etc. • Regularly operates a computer and other office productivity machinery, such as a calculator, copy machine, and computer printer. • Frequently communicates with (exchanges information, converses with, expresses oneself to), vendors, supervisors, community at large, and clients regarding treatment, management, incidents, other reporting, and advertising of services. • Must be able to determine accuracy of reports (figures, balances, documentation), perceive risk or agitation of clients, and to judge, observe, and assess situations germane to program operations. • Good verbal and written communications skills; articulation and instruction of policy procedure and practice. • Frequently exchange information in communication with individuals who are agitated, confrontational or difficult, and with colleagues from a variety of socio-economic, cultural, and religious backgrounds. • Occasionally move, position, or place files weighing up to 10 lbs. • Regularly required to traverse public transportation in order to attend meetings, give presentations, or meet with clients in the community. • Noise level is moderate. • Remote position, but will be office based at a future date. Remote work requires access to computer software. Frequently need to manage, manipulate or maneuver use of technological devices. • Occasional to frequent exposure to patients with infectious diseases.
Housing Works provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements. Housing Works complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.
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