Quality Assurance Specialist

Quality Assurance Specialist

The City of Alexandria is located in northern Virginia and is bordered by the District of Columbia (Potomac River), Arlington and Fairfax counties. With a population of approximately 150,000 and a land area of 15.75 square miles, Alexandria is the seventh largest city in the Commonwealth of Virginia. Alexandria has a charming waterfront and is a unique and historic place to live and work. If you are interested in working for the vibrant City of Alexandria, we invite qualified candidates to apply for our Quality Assurance Specialist position.

An Overview

The Quality Assurance Specialist performs Quality Improvement activities in compliance with federal, state, and CSB regulations related to documentation of consumer services, including extensive review of records. Maintains updated regulatory guidelines for the Department. Supports Department-wide management of client records. Performs data collection activities for program evaluation purposes.

What You Should Bring

The ideal candidate should have strong working knowledge of services provided for intellectual/developmental disability, mental illness and substance use clients; Knowledge of applicable State and Federal regulations; experience with accreditation standards for behavioral health programs; and extensive computer skills, including ability to use Microsoft Office Suite, SharePoint, and other applications. Ability to use databases to gather and synthesize information for writing of summary reports/analyses. Ability to communicate clearly and effectively both orally and in writing; ability to prepare and maintain complete and accurate reports and possess proficient computer skills.

The Opportunity

• Co-chairs the Policy and Procedure Committee
• Monitors/maintains the ACSB and selected DCHS Policies and Procedures, and policy review process, as well as regular intervals, notifies staff of policy updates/and changes.
• Revises/updates assigned policies and procedures.
• Maintains regulatory guidelines and requirements for the ACSB, keeping updated manuals and/or databases for CSB Licensure, CARF, and Medicaid and other third-party payers.
• Interprets regulatory rules and works with reimbursement, program evaluation, and clinical staff to provide training and consultation regarding compliance.
• Reviews case file documentation maintained by the ACSB staff members to determine the level of compliance with Department and external funding requirements, including, but not limited to, Medicaid, Medicaid Waiver, ACSB Licensure, Anthem, DMAS, Magellan, Aetna, Optum/United Healthcare, Optima, Medicare, CARF, and HIPAA.
• Conducts special audits as determined by QA Director and leadership team.
• Conducts Incident Reporting and Clinical Documentation training as part of New Employee Orientation.
• Maintains QA record review data and reports to senior leadership on results and trends regarding staff compliance with documentation requirements via an annual record review analysis.
• Provides training and support to staff in the use of the EHR, electronic clinical record system.
• Monitors/updates review indicators/review checklists and disseminates information about records, review outcomes to supervisors with recommendations for correction/improvement within a specified time frame.
• Conducts meetings with supervisors to discuss review results and ways to improve documentation.
• Reviews incident report data and prepares on an annual basis the Incident Report Analysis for the CSB from data obtained and interpreted via the Incident Reporting Database.
• Attends and provides agenda items for the Quality Assurance Committee.
• Uploads documents for audits and partakes in onsite audits.
• Serves on various Departmental and State committees, as assigned.
• Other duties, as determined by supervisor.

About the Department

The Center for Administrative Services (OAS) comprises Finance, Quality Assurance, Information Technology and Program Evaluation. Like the larger Department, DCHS, of which we are part, we are ethical stewards of the resources entrusted to us and are accountable for our actions. We communicate consistently, honestly and openly and demonstrate integrity in all aspects of our work.

Minimum & Additional Requirements

Four-Year College Degree in sociology, psychology, social work, human services, or a related area; three years of experience working directly in an administrative capacity with adults, youth and children with mental illnesses, intellectual disabilities or persons at risk of these disabilities; or any equivalent combination that provides the required knowledge, skills and abilities.

Preferred Qualifications

Bachelor’s Degree in social work or related field. At least two years of experience in the provision of crisis counseling and case management with the economically disadvantaged. Extensive knowledge of social, economic, health, and behavioral problems; At least one year of experience working with clients in crisis and engaging difficult to serve individuals and families.

Notes

This position requires the successful completion of pre-employment background checks including but not limited to: Criminal Records Check; VA State Child Abuse/Neglect Registry; Medicare/Medicaid Fraud Database; education/certifications; and driver’s license.

Schedule: Monday through Friday, 8: 00AM - 5:00PM. Occasional need to work nights and weekends for special projects/assignments.