Quality Assurance Specialist

7 days ago

New York, New York, United States The Child Center of NY Full time $60,000 - $120,000 per year


The Child Center of NY strengthens children and families with skills, opportunities, and emotional support to build healthy, successful lives. Founded in 1953, The Child Center of NY has become a powerful community presence throughout the city. With 50 locations and 100 programs in NYC's most under-served communities, our 1,000+ results-oriented professionals make a difference for more than 40,000 children and their families each year.



Summary 



The Quality Assurance Specialist is responsible for developing, monitoring and implementing strategic quality improvement processes in the Health Home & Integrated Care and Prevention divisions.  The Quality Improvement Specialist works with program directors and staff to assure the performance and quality of care and services for the persons and families served by The Child Center. 



Essential Functions: 



Work within and across divisions as needed to maintain up-to-date knowledge of the program, licensing body and accreditation regulations and ensure compliance.  

Work collaboratively to communicate and address any regulatory/policy changes that occur in order to ensure compliance with these rules and regulations. This includes researching and advising on regulatory compliance questions, as needed. 

Independently develop processes and procedures to ensure quality client services and compliance with professional standards, identifying deficiencies and creating/implementing improvement plans where necessary. 

Conduct billing reviews to ensure that Medicaid billing is supported by accurate documentation for Medicaid funded programs. 

Conduct chart reviews to ensure program compliance with all regulations, identify patterns/trends of challenges, and follow through on corrective actions for such. 

Maintain and ensure compliance with client and agency confidentiality standards and ethical expectations. 

Work collaboratively with program directors to review audit findings, develop corrective action plans, and monitor implementation of such plans, providing training/coaching when necessary.   

Independently develop benchmarks and tracking systems to ensure program improvement. 

Communicate with programs about performance and quality of care/services issues with the level of complexity that program staff are able to understand.  This level of complexity is up to the discretion of the QI specialist as per his/her expertise in understanding and interpreting quality and performance data for the given program. 

Advise senior management on issues such as program performance and quality matters by making educated and intellectual interpretations and summaries of quality and performance data. 

Work with program directors to develop standardized tracking and reporting for Incident Review, Compliance, and Quality Improvement meetings for assigned programs. 

Develop in-house expertise in the various electronic management systems used by assigned programs for data review, reporting, and billing purposes.  Address/train program staff in these systems. 

Perform other related duties as assigned.  

Supervisory Responsibilities: 

  • None 

  • Minimum Qualifications:  

  • Master's degree in a relevant field preferred (MSW, MPA, MS, MA) or equivalent experience. 
  • Prior experience with Medicaid funded program. 
  • Prior knowledge of Medicaid and HIPAA regulations. 
  • Ability to work independently on multiple tasks while meeting deadlines. 
  • Comfort level with large data sets, statistics and billing information. 
  • Excellent communication skills, both written and verbal with good public speaking and presentation skills. 

  • High level of skill with MS Office software including Word, Excel, Outlook and knowledge of management information systems.  

The Child Center of NY is an Equal Opportunity Employer.   All applicants will be considered for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status or any other category protected by Federal, State or local law.  EOE M/F/D/V


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