Quality Assurance/Compliance Officer Summary
The Quality Assurance Officer is responsible for facilitating and assuring in home care service provision are compliant with applicable Medicaid, Medicaid waiver, and other licensure and contractual requirements in the multi-office, regional territory of South Central and North Eastern PA.
Quality Assurance/Compliance Officer Essential
* Develop, review, revise and implement standardized state specific policies, procedures and work processes that comply with Medicaid and other regulatory/contractual payer agreements
* Educate branch leadership and staff on state regulatory and contract requirements.
* Perform on-site and desktop audits and monitoring to assess branch level compliance with applicable rules and regulations.
* Oversee and support external agency audit processes including audit preparation, deficiency remediation and corrective action planning.
* Monitor corrective action execution and drive accountability.
* Drive operational compliance and quality outcomes.
* Report internal and external audit findings at all levels including branch, regional and senior leadership.
* Facilitate investigation, reporting and resolution of critical incidents and complaints.
* Investigate requests for recoupments by reviewing records and documentation.
* Assist in acquisition due diligence, as needed.
* Performs other duties as assigned Quality Assurance/Compliance Officer Performance Responsibilities:
* Maintain positive internal and external customer service relationships
* Maintains open lines of communication
* Plans and organizes work effectively and ensures its completion
* Meets all productivity requirements * Demonstrates team behavior and promotes a team-oriented environment
* Actively participates in Continuous Quality Improvement
* Represents the organization professionally at all times
Quality Assurance Officer Requirements & Competencies:
* Bachelor's Degree in Business, Social Services, Public Administration, or a related field of study
* 3 - 5 years of experience in health care, social services or a related industry
* RN/LPN license preferred * Audit experience is preferred
* Some experience in a large, fast-paced, results-driven, multi-site organization
* Must possess strong communication, written, interpersonal and organizational skills
* Proficiency in using Microsoft Word, Excel, PowerPoint and Outlook, required.
* Ability to travel between all offices in South Central, PA
* Must be self-confident, thorough, and prompt in completing assignments and projects
* Passionate, energetic, tenacious and resolute, with a high sense of urgency and a strong drive to produce results
* Valid Driver's License Benefits Include:
* Competitive Pay
* 401k * Medical, Dental, Vision and Ancillary Benefits
* Mileage Reimbursement * PTO
Location/Region: Lemoyne, PA (17043)