Investigator And Quality Assurance Specialist

Specialist is a member of the Quality Assurance & Compliance team committed to utilizing data and extant technologies to maximize the effectiveness and efficiency of the organizations programs via Quality Assurance and performance improvement (QAPI) and reporting processes. The IQA Specialist assists in developing processes to collect and analyze data in addition to establishing activities to improve processes identified as in need of attention to ensure compliance with all state regulations, accrediting bodies, and standards of care. Will conduct Investigations Internal and External Regarding Clients and Staff and prepare and submit mandated Investigations by Regulatory Agencies

The IQA specialist monitors the QAPI activities, utilizes new and extant data collection procedures, audits, and statistical analyses to ensure the quality and appropriateness of the services delivered, seek to improve service delivery and healthcare outcomes, and maintain contractual reporting compliance. The QA Specialist will collaborate with program leadership in all QAPI activities.

1. RESPONSIBILITIES OF THE JOB AND ESSENTIAL ELEMENTS:

• Assists in the development of processes to monitor and ensure compliance with federal and local laws, regulations, and guidelines, including HIPAA, 42 CRF part2, etc.
• Develops and implements systems and procedures for the identification, collection, and analysis of performance measurement data.
• Implements the QAPI program in coordination with the Delaware Division of Substance Abuse and Mental Health (DSAMH) requirements.
• Conducts contract-specific performance monitoring in addition to performance monitoring of both process and client outcome studies.
• Performs mock licensing audits of required programs
• Performs mock accreditation surveys of required programs
• Reviews QA recommendations and follow ups to determine the effectiveness of interventions.
• Reviews established policies and procedures and provides recommendations as needed for modification.
• Collaborates in the development, delivery, and evaluation of educational programs and tools.
• Develops and reviews process for annual review of QA program to determine effectiveness
• Conducts Investigations Internal and External Regarding Clients and Staff and prepare and submit mandated Investigations by Regulatory Agencies
• Submits required reports within expected timeframes.
• Conducts Critical, PM-46, investigations, and other investigations as necessary
• Assists with Occurrence, Incident and Death Reporting processes.
• Provides leadership and assistance to all programs and directors in preparation for licensure and accreditation process or audits
• Provides timely, accurate, and concise documentation of programs
• Delivers and assess educational offerings
• Coordinates the employee training on EHR ensuring that all staff are adequately prepared to document all clinical encounters.
• Develops and implements comprehensive training programs customized for each position, related to the EHR and Medical Records policies.
• Coordinates staff access to the EHR and resolves any issues related to utilization of the system.
• Tracks the successful completion of training from the Learning Management System (LMS).
• Collaborates effectively with internal and external stakeholders
• Performs routine administrative functions.

• Performs other duties as requested or assigned, verbally or in writing.

• Other Responsibilities:
• Displays a competent knowledge of Agency policy and procedures as well as Federal and State Regulations. Keeps current with available resources.
• Encourages staff/clients while demonstrating self-initiative in problem solving.
• Assist in the development of data collection and analysis of the quality improvement projects.
• Maintains confidentiality, proper boundaries and an ethical relationship with clients and co-workers accordingly to Companys policies and as their Delaware Professional Board regulations.
• Ensures all client records are maintained according to agency standards, policies and procedures.
• Engages in professional development. Responsible for keeping current in the field. Completes seminars and/or continuing education programs, as appropriate to update knowledge about addiction and mental health services.
• Completes annual educational program as required.
• Participates in the development of quality improvement activities designed to enhance agency and program services
• Engages in professional development. Responsible for keeping current in the field by attending formal and agency trainings.
• Performs Other Duties as Needed

1. MINIMUM EDUCATION AND EXPERIENCE QUALIFICATION REQUIREMENTS:

• Preferred Education: A Bachelors degree in health sciences, public health, social science, program management, public administration, business administration or related field.
• Three years of work experience in compliance, regulation, or accreditation.
• Experience interpreting accreditation standards, policies and regulations.
• Proficiency with spreadsheets, database software, and Microsoft Office suite of software.
• Preferred Experience:

• Electronic health record system(s)
• Knowledge of Commission on Accreditation of Rehabilitation Facilities (CARF) standards
• Knowledge of Practical, Robust Implementation and Sustainability Model (PRISM)
• Knowledge of Substance Use Treatment and Recovery Transformation (START) Program

• Certification by a healthcare quality organization such as Institute for Healthcare Improvement (IHI), Agency for Healthcare Research and Quality (AHRQ), National Association for Healthcare Quality (NAHQ), or National Committee for Quality Assurance (NCQA) is preferred
• Certification in Quality Improvement methods (Six Sigma, ASQ, CPHQ, etc.) preferred.
• CPR and First Aid

1. REQUIRED SKILLS:

• Ability to deal with diverse populations
• Ability to route patient's problems and concerns to appropriate sources
• Ability to stay within boundaries of the role and function of position
• Critical thinking skills
• Organizational skills
• Communication skills
• Ability to evaluate and comprehend techniques, procedures and changes to meet variable situations
• Able to effectively communicate with supervisors and directors to improve his/her skills and adapt to Agency culture and policies.

1. NETWORK FUNCTIONS:
   • Maintain and abides by OSHA requirements and guidelines
   • Observes all Fire and Safety Policies and Procedures
   • Observes all Personnel Policies and Procedures
   • Observes all Agencys Policies and Procedures
   • Observes all DE DOH-DHSS, CARF and DSAMH Regulations.
   • Observes all HIPAA Policies and Procedures and maintains confidentiality
   • Completes and returns all paperwork distributed by the Human Resource Department
   • Attends all required and scheduled trainings and meetings
   • Always maintain a professional demeanor and exercise good professional judgment in all areas of employment duties
   • Documents time worked accurately
2. EQUIPMENT/MACHINES:
   • EQUIPMENT OPERATIONS:
     • Telephone, cellular telephone, copier, fax, computer, calculator
   • COMPUTER SOFTWARE APPLICATIONS:
     • • Computer literacy in MS Office products; Word, Excel, Outlook, Power Point.
       • Agency Electronic Medical Record and other software programs

1. PHYSICAL DEMANDS:
   • Individual must be able to meet physical requirements of the job:
     • • Sitting at a meeting table or desk - Reaching - Lifting - Bending - Standing - Stooping - Twisting - Climbing steps - Driving a vehicle

1. ACCIDENT, HEALTH HAZARD AND SECURITY KNOWLEDGE:
   • Blood borne Pathogens, Right- To- Know, HIPAA, Security Acts, Fire & Safety
2. WORKING CONDITIONS:
   • Office environment.
   • Multiple levels of stairs.

1. ADHERE TO AND FOLLOW:
   • • The By-Laws of the Corporation and as set forth in the Articles of Incorporation