Description
As a Quality Assurance (QA) Analyst, you will collaborate with team members to support our clients through today’s ever-changing healthcare landscape. Your day-to-day role as a consultant will be to provide analysis expertise to evaluate the performance of the Social Adult Day Cares (SADCs) across New York State and their compliance with the Home and Community Based Services (HCBS) regulations.
Duties
- Evaluate the case for compliance to applicable regulations.
- Clearly communicate evaluation requirements and follow up in writing.
- Review and evaluate documentation against applicable State/Federal regulations.
- Collect data and documentation to support compliance findings.
- Record, summarize, and communicate compliance findings through written communication for the program.
- Assist in determining trends in non-compliance.
- Make appropriate and timely recommendations to project management.
- Assist with the ongoing operationalization of project’s processes and procedures.
- Assist with all internal and external reporting, as needed, and related to QA reviews.
- Build and maintain relationships with stakeholders to provide high level customer service.
- Any other tasks as requested by the client.
Mandatory Requirements
- Experience (8+ Years)
Requirements
- This is a 50% Onsite
- Bachelor’s degree in public health, healthcare management, psychology, human services, business, management, or related field and at least 2 years of relevant experience.
- A minimum of 2 years of experience as an auditor, compliance analyst, care manager, medical records reviewer, chart reviewer, or quality assurance analyst.
- Experience with monitoring program compliance or Medicaid fee-for-service and/or Managed Care billing.
- Proficiency in MS Excel, MS Word, MS Outlook, MS PowerPoint, and MS SharePoint.
- Exceptional customer service relationship techniques and communication skills.
- Excellent accuracy and attention to detail.
- Experience in meeting deadlines and adhering to strict standards of performance.
Preferred Skills:
- Knowledge of, and experience with, Social Adult Day Care.
- Knowledge of, and experience with following state and federal regulations, and enforcing compliance activities of third parties.
- Experience working with NYS Department of Health (DOH), Office of Mental Health (OMH), Office for People with Developmental Disabilities (OPWDD), or Office of Children and Families (OCFS).
- Ability to work with and relate to staff and demonstrate active listening skills.
- Process oriented and results-driven work strategy.
- Ability to foster teamwork with all levels of management and staff.
- Ability to work well independently and within a team.