Quality Assurance Case Review Specialist

COOK INLET TRIBAL COUNCIL, INC.

JOB DESCRIPTION

Job Title:          Quality Assurance Case Review Specialist

Department:    Employment & Training Services Department (ETSD)

Reports To:      Senior Manager

Supervises:      None

FLSA Status:   Exempt

Pay Grade:       E4

Job Type:         Regular, Full-Time

AKBCU:            Yes      ICPA: Yes

General Functions:

The Employment and Training Services Department (ETSD) Quality Assurance Case Review Specialist is responsible for investigating and evaluating data integrity and accuracy in participants' files to determine the timeliness and quality of services through the dissemination or eligibility and case management processing for financial assistance programs. The Quality Assurance Case Review Specialist will provide summaries of case findings and provide trend analysis that will guide staff training to ensure departmental needs encompasses the set goals and expectations of CITC’s products, services, and processes to be of the highest standards in alignment with our values.  

Duties and Responsibilities, including but not limited to:

Become proficient with regulations, policies, and procedures associated with financial assistance programs.

• In partnership with ETSD management, monitor the data integrity and accuracy within the ETSD data systems to ensure alignment with CITC, CARF and other funding performance requirements and outcomes.
• Updates and assist with maintenance of ETSD databases.
• Supports the Sr. Director/Sr. Program Managers with development of monthly, quarterly and bi-annual grant reports.
• Assists all programs in meeting established goals and objectives of grants.
• Assist in updating and/or reviewing program documents to include but not limited to intake forms, orientation packets and workshop schedules. 
• Answer queries and provide the information needed in the ETSD Databases to Senior Director and Managers as needed to tracking services.   
• Monitors the file reviews by staff persons and program to ensure alignment a with CARF requirements. 
• Conduct comprehensive quality assurance case file reviews of individual cases to ensure compliance with established standards and protocols. 
• Analyze and evaluate case documentation, identifying discrepancies and areas for improvement. Document trends and provide suggestions to mitigate errors.
• Collaborate with cross-functional teams to address quality issues and implement corrective actions.
• Develop and maintain detailed documentation of quality assurance processes and findings.
• Develop and implement training on regulations, policies, procedures and best practices Provide feedback in the development and implementation of corrective and preventative actions to team members to enhance overall performance and adherence to quality standards.
• Support Eligibility and Case Management staff by making recommendations to direct management related to case actions taken and areas of improvement. 
• Participate in the development and improvement of quality assurance policies and procedures to enhance efficiency and effectiveness.
• Generate regular reports on quality assurance metrics and present findings to management and at CQM Meetings.
• Prepare comprehensive reports summarizing findings, trends, and recommendations.
• Communicate findings to relevant stakeholders and provide updates on quality metrics through meetings, quarterly and bi-annual staff training as directed.
• Work in partnership with other departments to identify opportunities for process improvement.

Job Specifications:

• Strong analytical skills, attention to detail.
• Excellent verbal and written communication skills.
• Demonstrated ability to systematically review and evaluate cases to maintain and enhance overall quality. 
• Demonstrated ability to read, analyze and interpret general business periodicals, professional journals, technical procedures, or governmental regulations.
• Demonstrated ability to compute ratios and interpret graphs.
• Strong problem-solving skills.
• Demonstrated ability to coordinate multiple activities.
• Demonstrated ability to work as an active participant in a team environment.
• Demonstrated strong computer skills.
• Demonstrate strong group/team facilitation skills.
• Maintain a positive working relationship with CITC staff.
• Maintain confidentiality of CITC participants and staff following all applicable rules governing confidentiality, HIPAA, and CFR 42.

Minimum Core Competencies: CITC Values, Respectful Leadership, Professionalism, Emotional Intelligence, Problem-Solving/Critical Thinking, Communication Skills 

Minimum Qualifications:

• Bachelor's degree in business management or similar field, or year for year may be substituted for degree.
• Minimum of two years of program management and/or program monitoring experience. 
• Continued employment is contingent upon receipt of a satisfactory report from a state and federal background check.

Preferred qualifications:

• Experience with program management, writing quarterly reports, administering funds.
• Experience working with Alaska Native people, knowledge of their values and belief systems and ability to provide culturally competent services.

Physical Requirements: 

NATIVE PREFERENCE STATEMENT: Pursuant to the Indian Self-Determination and Education Assistance Act of 1975 (PL 93-638) and as further guided by CITC’s Native Preference Policy 6.120, CITC maintains preference in all phases of employment for Alaska Natives, American Indian (AN/AI) and Native Hawaiian people, including direct lineal descendants and foster or traditionally adopted children. Also included are the non-Native head of household members for Native families, which includes foster or traditionally adopted Native children.

Disclaimer

The information provided in this description has been designed to indicate the general nature and level of work performed by incumbents within this job.   It is not designed to be interpreted as a comprehensive inventory of all duties, responsibilities, qualifications, and working conditions required of employees assigned to this job.   Management has sole discretion to add or modify duties of the job and to designate other functions as essential at any time.  This job description is not an employment agreement or contract.