ARISE​/Family Resources Quality Management Specialist

Overview

Arise is looking for a Quality Management Specialist. The Quality Management Specialist is responsible for reviewing quarterly and annual SRI reports from the waiver providers, assisting RRDS in reviewing Service Plans upon request to ensure information is accurate and meets the health and welfare needs of the participant, and overseeing the Serious Reportable Incident process, assuring compliance and the timely completion and submission of all required documentation associated with the investigatory process both internally with the RRDC and with the waiver providers across an 8-county region.

• Submit a monthly numbers report for the NHTD/TBI to DOH waiver staff.
• Submit quarterly complaint reports for NHTD/TBI to DOH waiver staff.
• Make recommendations to the Lead RRDS/DOH based on experience for improvements to NHTD/TBI waiver policies and procedures.
• This position reports to the RRDC Manager/Assistant Director of LTC Programs.

• Proficient computer skills, especially with Microsoft Suite; demonstrated ability to learn new computer systems and software.
• Excellent communication skills both in person as well as on the phone.
• Ability to gather important information from individuals and share/capture in a variety of methods; excellent ability to present information to a variety of audiences.
• Strong organizational skills with physical and electronic records and data.
• Working knowledge of community-based resources and services, operation of 1915 (c) waivers, issues concerning individuals with disabilities and seniors, and benefits provided by Medicaid, Medicare and/or other third-party payers.
• Clean Driver License and inspected, insured, reliable transportation.
• Educational Qualifications (candidates must meet at least one of the criteria listed below):
• Possess a bachelor’s degree in health or human services or a related field and two years of combined satisfactory professional experience in working with individuals with disabilities and/or seniors, including in a managerial capacity.
• OR Be a Registered Professional Nurse and have one year of combined satisfactory professional experience working with individuals with disabilities and/or seniors, including in a managerial capacity.
• OR Possess an Associate degree and five years of combined satisfactory experience working with individuals with disabilities and/or seniors, including in a managerial capacity.

• Track all pertinent information pertaining to SRIs for analysis to identify any regional trends and emerging issues.
• Perform internal DOH RRDC file reviews of a sample of participant records quarterly and confirm adherence to proper authorization procedures and satisfaction of waiver requirements.
• Perform waiver provider service audits across an 8-county region with 40 plus providers.
• Perform trend analysis identifying problematic areas across an 8-county region, and develop activities/trainings that will support positive outcomes.
• Develop, implement, and ensure completion of plan of corrective actions.

Work location:

Onondaga County - Syracuse, NY.

Hours and days:
Monday-Friday 8:00am - 4:00pm (Tentative work from home schedule - once trained).

Compensation: $25.00 - $26.00 Per Hour.

Non-Exempt; 40 hours per week, including one-hour paid lunch.

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