Summary:

The Quality Assurance Specialist is a key member of the Quality Assurance, Compliance and Risk Management team who supports and assists all agency programs as well as Finance, staff, and other stakeholders to facilitate Medicaid information for persons served. This position assures accuracy in individual support plans (know services, units, language) and billing authorizations for individuals served and is responsible for the coordination and implementation of Fee for Service projects (annual reports, ISP program objectives, PCPT) agency wide. Responsibilities Develop Individual service plans including updating and maintaining Electronic Health records. Participate as a member of an inter-disciplinary team in the development and implementation of Service Plans for the individuals served. Serve integral role in service intakes by capturing and communicating the requisite information to determine appropriate placement in the organization. Review Individual Support Plan submissions and communicate need for changes with Support Coordinators. Develop licensing strategies and NJ ISP goals that will foster independence and support served individuals in their dreams and desires. Work closely with Support Coordinators outside of the organization. Monitor, identify and resolve problems, and when necessary, route requests to internal and external resources to problem-solve. Deliver excellent customer services with a high degree of flexibility and independent judgement following standardized operating procedures to internal and external customers. Serve as a liaison between internal and external providers and other stakeholders. Complete quality checks for SDR Units before submission to the Billing Specialist and Department Leads. Develop and implement methods and techniques within the ISP program and the community to attain the Service Plan goals for the individuals served. Prepare and/or oversee preparation of electronic records such as survey summaries, service annual reports, and other reports as needed. Conduct and/or participate in meetings, take minutes, attend trainings and workshops serve on committees, and other events as assigned. Complete quality checks of documentation in Electronic Health Records. Review/Initiate/Record Incident reports. Update UIR tracking Spreadsheet. Conduct and participate in investigations, complete report of the investigation. Maintain highest level of confidentiality and adheres to related Department HR and policies in regard to staff actions. Advocate in the best interest of the individuals served. Perform other duties as assigned. Cooperate with inspections, investigations and inquiries conducted by The Arc of Monmouth and/or by The New Jersey Division of Developmental Disabilities and The New Jersey Department of Human Services. Qualifications Bachelor's degree in social services, public health, business, computer science, related field or equivalent work experience is required. Strong written and verbal and excellent computer skills are mandatory. Must possess superior customer service skills and be able to demonstrate the capacity to work effectively with electronic health records. Experience with Therap Services a plus. The successful candidate will exercise judgement in prioritizing daily activities and problem solving and must be able to work effectively with team members across service lines such as residential, individual supports, health services and day habilitation. Must have a valid N.J. driver's license and driving record which is acceptable to The Arc and its insurer. Must present evidence of pre-employment physical examination, Mantoux test, criminal background, central registry, child abuse registry and drug testing.

Pay:

$47,000.00 - $53,000.00 per year

Benefits:

403(b) Dental insurance Health insurance Paid time off Referral program Tuition reimbursement

Work Location:

In person