Quality Management Specialist (62049)

Job DetailsJob Location: Main Office - Syracuse, NY 13208Salary Range: $25.48 - $25.96 HourlyIndera is looking for a Quality Management Specialist, NHTD/TBI

At Indera we envision a world where disability never limits opportunity,

and every community is built for everyone.

Indera is dedicated to promoting independence and enhancing quality of life for the individuals we serve. As an Equal Opportunity Employer, we welcome and encourage applications from candidates of all backgrounds, including individuals with disabilities, and are committed to providing the support, accommodations, and resources needed to help every employee achieve their personal and professional goals.

Job Responsibilities

Incident Reporting

Assist with Serious Reportable Incident process, assuring compliance and the timely completion and submission of all required documentation associated with investigatory process both internally with the RRDC and with the waiver providers across an 8-county region
Track all pertinent information pertaining to SRIs for analysis to identify any regional trends and emerging issues

Quality Monitoring

Perform internal DOH RRDC file reviews of a sample of participant records quarterly and confirm adherence to proper authorization procedures and satisfaction of waiver requirements
Perform waiver provider service audits across an 8-county region with 40 plus providers
Perform trend analysis identifying problematic areas across an 8-county region, and develop activities/trainings that will support positive outcomes
Develop, implement, and ensure completion of plan(s) of corrective actions
Ensure waiver participants complete annual participant satisfaction surveys using the DOH designated form to assess participant satisfaction with NHTD/TBI waivers and to monitor quality assurance activities

Review of Services Plans and Provider Applications:

Assist RRDS in reviewing Service Plans upon request to ensure information is accurate and meets the health and welfare needs of the participant
Assist with provider enrollment process and submission to DOH

Develop and Submit Reports to DOH

Review quarterly and annual SRI reports from the waiver providers
Submit a monthly numbers report for the NHTD/TBI to DOH waiver staff
Submit quarterly SRI reports for NHTD/TBI to DOH waiver staff
Submit quarterly complaint reports for NHTD/TBI to DOH waiver staff
Make recommendations to the Lead RRDS/DOH based on experience for improvements to NHTD/TBI waiver policies and procedures

Professionalism

Uphold the codes of conduct and ethics as well as all Indera policies and procedures
Exercise sound judgment as a matter of course and hold protected health information and other sensitive information in the strictest of confidence in accordance with Indera and HIPAA policies
Other duties as assigned

Confidentiality: High-level confidentiality is required for access to all organization records.

Safety Compliance: Office functions are performed while maintaining a safe work environment.

Qualifications

Proficient computer skills, especially with Microsoft Suite; demonstrated ability to learn new computer systems and software
Excellent interpersonal skills both in person as well as on the phone
Demonstrated professional verbal and written communication skills; ability to gather important information from individuals and share/capture in a variety of methods; excellent ability to present information to a variety of audiences
Strong organizational skills with physical and electronic records and data
Working knowledge of: community-based resources and services, operation of 1915 (c) waivers, issues concerning individuals with disabilities and seniors, and benefits provided by Medicaid, Medicare and/or other third party payers
Clean Driver License and inspected, insured, reliable transportation
Experience in person centered planning and team building
Ability to review and analyze records, reports and surveys in order to determine trends
Proven ability to assist program development

Educational Qualifications (candidates must meet at least one of the criteria listed below):

Possess a bachelor’s degree in health or human services or a related field and two years of combined satisfactory professional experience in working with individuals with disabilities and/or seniors

OR

Be a Registered Professional Nurse and have one year of combined satisfactory professional experience working with individuals with disabilities and/or seniors, including in a managerial capacity

OR

Possess an associate degree and five years of combined satisfactory experience working with individuals with disabilities and/or seniors, including in a managerial capacity

Work location: James Street Office located in Syracuse - Onondaga County

Hours and days: Monday-Friday 8:00am -4:00pm (Approx)

Compensation: $25.48 -$25.96 per hour

Non -Exempt- Full Time

40 hours per week, including one-hour paid lunch