Quality Improvement Records Specialist / Auditor

Job Title:                           Quality Improvement Records Specialist / Auditor

Reports to:                      Director of Quality Improvement (QI) and Corporate Compliance

Grade:                                Level 5

FLSA Status:                   Non-exempt

 

Summary:  The purpose of this position is to support ARISE’s continuous quality improvement initiatives in the areas of auditing, incident and compliance investigations and program quality assurance.  As a result, ARISE will increase its efficiency regarding implementation and monitoring of corrective action plans, staff training and adherence to regulatory and funding requirements. Must hold sensitive information in the strictest confidence, exercise sound judgment as a matter of course, and uphold professionalism.

 

 

Essential Functions:

  1. Responsible for:
    • Timely and accurate compliance and incident management data entry in the ARISE database and other incident databases (including OPWDD IRMA, etc)
    • Preparing letters, written notifications, and other mailings
    • Assisting with maintaining current forms, policies, and templates, and uploading current resources and departments’ announcements on the Staff Homepage
    • Assisting with responding to records requests and subpoenas, including the gathering, reviewing, copying, and delivery of requested records
    • Assisting with Incident Reporting notifications and documentation as required by regulatory agencies
    • Coordinating the scheduling of meetings, including room reservations, meeting announcements, and preparation of materials for meetings and trainings
    • Using an electronic device (laptop or tablet) take minutes for established committee meetings; document discussions, summary of findings, action items and follow up items
    • Organizing the periodic archiving of agency records for offsite storage. Provides technical assistance to program and department managers to ensure appropriate completion and arranges for deliver and pick up of archived files.
    • Working with QI Director and Investigators to maintain organized, current files for incident and compliance investigations; to include all required forms, correspondence, supporting documents, interview notes, meeting minutes, recommendations, and follow up for each case. Accompany investigators as needed on investigative interviews.
    • Checking the anonymous Corporate Compliance Hotline daily and document; immediately inform the Director of QI upon the receipt of any new messages
    • Assisting with preparation of training materials (HIPAA, Incident Reporting and Corporate Compliance, etc.) and assist with training as needed
    • Assisting with completing required Exclusionary Screenings and archiving of results
    • Maintaining all audit related data and work with QI team to compile annual report including statistics and trend analyses
  2. Conduct internal audits/reviews of control procedures by examining records, reports, operating practices, service and billing documentation etc. and develop recommendations for improved quality and compliance regulations
  3. Communicate audit findings by preparing a final report and reporting findings to QI Director/Compliance Officer and as requested by QI Director to program management, and established applicable committees
  4. With QI Director’s guidance, work collaboratively with agency leadership regarding internal reviews and audits to adopt best practices and continuous quality improvement in all areas of the agency
  5. Collaborate with internal service providers and other outside agency providers for audit purposes
  6. Assist with the ongoing development of agency Quality Assurance/Quality Improvement processes and policy development
  7. Attend required workshops and trainings
  8. Actively take steps to implement the agency’s compliance program and the Code of Conduct
  9. Other duties as assigned

 

 

Qualifications:

  • Bachelor degree or equivalent combination of education and experience preferred, minimum Associates degree
  • Previous experience in a QI Auditing role or similar administrative position preferred at a human service agency whose programs are funded by Medicaid, the Office for People with Developmental Disabilities (OPWDD) and/or Office of Mental Health (OMH)
  • Audit, compliance and documentation skills
  • Working knowledge of programmatic, fiscal and regulatory requirements of OPWDD, OMH, Medicaid, and Office of Civil Rights HIPAA regulations
  • Ability to read and interpret regulatory agency rules and regulations
  • Strong writing and analytical skills to analyze data and present information
  • Proficient in MS Excel and Word, familiar with Access
  • Excellent oral and written communication skills
  • Detail oriented, accuracy with keen attention to detail
  • Excellent organization and record keeping skills
  • Successful completion of NYS OMH and/or OPWDD-approved Incident Reporting and Investigation Training courses (Basic through Advanced) as directed post-hire, unless recently certified (valid certifications required)
  • Knowledge of Central New York human service agencies and resources
  • Demonstrated ability to work in a fast-paced environment while balancing multiple projects and deadlines
  • Ability to work independently and as a member of a team, follow written and verbal instructions
  • Reliable transportation to travel as required for audits across four counties, attend regional trainings, etc.