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E00830 – Corporate Quality Assurance Strategist

Full-time Position

Contact Center

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Position Overview: Under the supervision of the Senior Quality Assurance Strategist and in collaboration departmental leadership, the Quality Assurance Strategist is responsible for the implementation, management, coordination and oversight of RCA’s Quality Assurance (QA) Performance Improvement (PI), and Compliance activities for corporate service lines to include but not limited to: mission center, recruiting, credentialing, and billing. The Quality Assurance Strategist will provide direct oversight to the Quality Assurance Assistants; ensuring daily, weekly, monthly quality assurance tasks are completed.

 

 

Daily Responsibilities Include:

 

  • Provide direct daily supervision to departmental Quality Assurance Assistant
    • Provide regular supervision and feedback to support department initiatives
    • Ensure training is completed as required
    • Provide feedback to ensure ongoing staff competencies and development

 

  • Chart/Analytics Reviews
    • Ensure completion and accuracy of monthly qualitative review: identify trends and strategize appropriate performance improvement strategies
    • Respond to priority issues (PIP/DCO/CAP); ensuring comprehensive chart review and communication of results to leadership
    • Monitor efficacy of performance improvement plans and make recommendations based upon data and trending
    • Make recommendations for proactive reviews to mitigate risk and ensure consistency in service delivery and documentation
  • Risk assessments
    • In collaboration with the Senior Risk Manager, develop and implement a standardized process self risk assessments to include annual assessments and monthly reviews
    • Provide governance over self identified risk areas and risk ratings; utilizing data to drive justifications of risk ratings
    • Develop Performance Improvement Plans
    • Establish ongoing monitoring and measures for success

 

  • QA Reports
    • Ensure QA reports are operationalized to include discussion in daily site meetings (FLASH, treatment team, etc.) and timely, appropriate response is occurring organizationally
    • Work collaboratively with leadership regarding performance improvement and/or barriers in response
    • Develop logic for build of reporting and analytics; work with IT and departmental leadership to build out reporting that meets the needs of the operation and provides quality analytics
    • Ensure ongoing awareness of report enhancements, report development, and/or analytics; collaborate with training to ensure appropriate and regular training occurs

 

  • Incident Reports
    • Oversee Incident Reporting process to include incident follow up, internal/external reporting, trends, and Performance Improvement strategies for risk mitigation are addressed
    • Collaborate with training to ensure appropriate and regular training occurs
    • Conduct investigations and ensure appropriate leadership is involved (interviews, review of footage, root cause as needed)

 

  • Grievances
    • Follow up and respond to all grievances, CRM and/or ACTS calls in a timely and appropriate manner
    • Assist leadership in identifying areas for improvement; to include implementation of performance improvement, as necessary
    • Ensure regular leadership updates regarding trends in grievances, CRM calls, and/or ACTs calls

 

  • Patient Satisfaction Surveys
    • Monitor Patient Satisfaction comments regarding corporate service lines
    • Implement performance improvement strategies based upon weekly and/or monthly trending
    • Utilize appropriate tools (portals/dashboards, etc) to ensure data analysis, outcomes, and/or PI supports are discussed and responded to on a regular basis

 

  • Weekly Leadership Meetings
    • Provide leadership with weekly data/information as requested
    • Assist in development of performance improvement plans as needed

 

  • Monthly Environment of Care Walkthroughs
  • Participate in ECO walkthroughs and document areas for improvement.
  • Assist in development and monitoring of PIPs as needed

 

  • Policy & Procedure and Protocol Governance
    • Ensure protocol development has been reviewed/approved by governing committee
    • Ensure facility feedback prior to P&P meeting on upcoming P&P

 

  • Plan of Corrections (DCOs, CAPS, PIPS)
    • Assist in development
    • Monitor completion
    • Ensure appropriate follow up

 

  • Regulatory and Accreditation Awareness
  • Ensure ongoing and comprehensive awareness of regulatory and accrediting requirements
  • Complete TJC intracycle monitoring

 

 

Overall Strategic Responsibilities:

 

  • Strategic oversight encompasses all organizational areas to include but not limited to: risk management, patient satisfaction surveys, regulatory/payor/accreditation compliance, clinical outcomes management, clinical programming, quality management committees, coordination of care, models of supervision, system validity/reliability, and operational efficiency. Strategic oversight includes:

 

  • Implementation and monitoring of performance improvement plans and strategies

 

  • Proactive analysis of systems and processes that underscore adverse/high-risk events and/or decline in measurement scores and implement action steps to address

 

  • Proactive project management for implementation of quality initiatives

 

  • Ongoing survey readiness and education of all levels of staff in regulatory, accreditation, and organizational expectations

 

  • Collaboration with leadership in completion of internal reviews to mitigate areas of risk; develop protocols and/or make recommendations for improvement

 

  • Work in a multidisciplinary manner to facilitate open communication across departments and roles

 

 

Education and Experience:

  • Bachelor’s degree in a related field (healthcare management, psychology, social services, nursing); master’s preferred
  • Five years of clinical experience and two years quality management experience with a focus on behavioral healthcare preferred
  • Understanding of systems of quality measurement/management and evidence based practices (American Society of Addiction Medicine, Substance Abuse and Mental Health Services Administration, Healthcare Effectiveness Data Information Set, National Committee for Quality Assurance, National Institute on Drug Abuse, National Alliance on Mental Illness)
  • Understanding of Risk Management best practices as governed by the American Hospital Association, American Society for healthcare risk management
  • Previous experience implementing systems and process to include organizational change management
  • Understanding of managed care to include commercial insurance and CMS governance (Medicaid/Medicare)
  • Experience and knowledge of ongoing survey readiness and survey processes to include federal regulations, state regulations, Joint Commission, and Commission on Accreditation of Rehabilitation Facilities (CARF surveys and standards.
  • Experience working with and developing solutions within electronic health records
  • Proficiency in Microsoft Office products (Office, Excel, Project)
  • Excellent organizational skills required

 

 

Competencies:

 

Integrity: Upholds personal and professional ethics and values, considering the values of the organization and respecting the culture, beliefs, and abilities of individuals.

Confidentiality: upholds organizational, patient, and employee confidentiality at all times.

Customer Service: Demonstrates concern for meeting internal and external customers’ needs in a manner that provides satisfaction for the customer within the resources that can be made available.

Impact and Influence: Works effectively with and through others including those whom there is no formal authority over.

 

Communication: Communicates well both verbally and in writing, creates accurate and punctual reports, delivers presentations, shares information and ideas with others, has good listening skills.

 

Work Environment: This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, and filing cabinets. The noise level in the work environment is usually moderate.

 

Physical Demands: The employee is occasionally required to stand; walk; sit; reach with hands and arms; climb or balance; and stoop, or kneel. Specific vision abilities required by this position include close vision, distance vision, color vision, peripheral vision and the ability to adjust focus.

 

Organization: Time Management: Determinates the appropriate allocation of time. Task Management: Balances conflicting priorities in order to manage workflow, ensure the completion of essential projects, and meet critical deadlines.

 

Judgment: Exhibits sound judgment and the ability to make reasonable decisions in the absence of direction; swiftly refers problems/issues to the appropriate person(s) when necessary; works effectively without constant and direct supervision or guidance.

 

Technical/Computer Skills: Displays proficiency using standard office equipment. Demonstrates advanced proficiency by quickly adapting to new technology and easily acquiring new technical skills

 

Project Management: Coordinates the diverse components of the project by balancing scope, time, cost, and quality.

 

Work Environment: This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, and filing cabinets. The noise level in the work environment is usually moderate.

Physical Demands: While performing the duties of this position, the employee is regularly required to talk or hear. The employee frequently is required to use hands to finger, handle or feel objects, tools or controls. The employee is occasionally required to stand; walk; sit; reach with hands and arms; climb or balance; and stoop, or kneel. Specific vision abilities required by this position include close vision, distance vision, color vision, peripheral vision and the ability to adjust focus.

 

Travel: 10% travel is required which includes local, out-of-the-area, and overnight travel.

 

 

 

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