Quality Assurance Specialist

COOK INLET TRIBAL COUNCIL, INC.

JOB DESCRIPTION

Job Title:          Quality Assurance (QA) Specialist I/II/III

Department:    Administration

Reports To:      Quality Assurance Supervisor

Supervises:       None 

FLSA Status:    Non-Exempt 

Pay Grade:        N3 (I), N4 (II), N5 (III)

Job Type:          Full-Time, Regular  

AKBCU:             No       ICPA: No 

General Functions:

This position is overseen by the Quality Assurance Supervisor. This position will be responsible for chart reviews, review of services, validating the quality of service delivered, appropriateness of service delivered, delivery of specific evidenced-based curriculum and practices, ensuring adherence to implementation of specific protocol, weekly quality assurance reports, training staff members on functionality of Electronic Health Records and Case Management System(s) to create accurate charting; as needed, to ensuring departmental needs encompasses the set goals and expectations for services provided within CITC.

Duties and Responsibilities:

Quality Assurance Specialist I

• Provide a documented chart review of group schedules, group content, treatment plan, diagnosis, clinical services and other program that require services, for adherence to program structure, therapeutic communities and system of care.
• Audit documentation that is entered into Electronic Health Record(s) for accuracy, following outlined curriculum and identifying common errors to ensure compliance with Commission on Accreditation of Rehabilitation Facilities, National and State accreditations and licensing bodies.  
• Assigned by QA Supervisor, provide quality assurance reviews within Electronic Health Record(s), to include reviewing the quality of service delivery, appropriateness of the services, key components of the evidence-based practices, and frequency of services.  
• Assigned by QA Supervisor, conduct quarterly, bi annual and annual review of clinical services, adherence to Continuous Quality Management procedures (CQM) and policy and procedures including fidelity for evidence-based practices when identified and used within the programs.
• Complete weekly crosschecks, spreadsheets and reports as assigned.
• Ensures adherence to confidentiality and HIPAA regulations.
• Provide ongoing guidance to program staff on the Electronic Health Record(s) clinical & non-clinical documentation procedures and related to functionality.
• Ensure documentation within Case Management System(s) and Electronic Health Record(s) conform to CITC’s policies and procedures.
• Provide clear comprehensive support through face to face interactions with staff, email, telephone contacts and webcasted telecommunication (Microsoft Teams, Zoom, etc.).
• Ensure that reviews are conducted on charts and forms they have not personally approved.
• Maintain confidentiality according to regulations, policies and procedures. 
• Perform all related duties as assigned.

Quality Assurance Specialist II

• Perform all duties and responsibilities of Quality Assurance Specialist I with a higher level of proficiency.
• Support Supervisors & Managers on reviewing, approving and rejecting forms and documentation within Electronic Health Record(s).  This includes identifying documentation errors and providing support for corrections.
• Assist with developing and updating a working user manual for Electronic Health Record(s) and Case Management System(s).

Quality Assurance Specialist III

• Perform all duties and responsibilities of Quality Assurance Specialist II with a higher level of proficiency.
• Provide ongoing guidance to staff on the Electronic Health Record(s) and Case Management System(s)’ procedures, chart documentation as related to their functionality, and ensuring applications conform to CITC’s policies and procedures.
• When assigned by QA Supervisor, provide quality assurance support to include reviewing daily error messages and fix request(s).
• Assist in training new QA Specialist staff on QA procedures and reports.
• Assist with training Supervisors and Managers on how to review, approve and reject clinical and non-clinical forms and documentation within Case Management System(s) and Electronic Health Record(s). This includes identifying documentation errors and support for corrections.
• Perform all related duties as assigned.  

Job Responsibilities Related to Participant Privacy

• Employee is expected to actively participate in CITC privacy training and to protect the privacy of participant information in accordance with CITC's privacy policies, procedures and practices, as required by federal and state law.  Failure to comply with CITC's policies and procedures on participant privacy may result in disciplinary action up to and including termination of employment.
• Employee may access protected health information and other participant information only to the extent necessary to complete job duties.  Employee may only share such information on a need to know basis with others who have job responsibilities related to treatment, payment, or other CITC operations.
• Employee is encouraged and expected to report, without the threat of retaliation, any concerns regarding CITC's policies and procedures on participant privacy and any observed practices in violation of the policy to the designated Privacy Officer.

Job Specifications:

• Excellent verbal and written communication skills, including face to face communication, email, telephone and webcasted telecommunication.
• Proficient use of personal computer and standard office equipment.
• Demonstrated ability to read, analyze and interpret general business periodicals, professional journals, technical procedures, or governmental regulations.
• Demonstrated ability to work independently with minimal supervision.
• Demonstrated ability to prioritize workload.
• Excellent time management skills.
• Demonstrated ability to coordinate multiple activities.
• Strong problem-solving skills.
• Demonstrated ability to work as an active participant in a team environment.
• Strong group/team facilitation skills.
• Must have strong writing skills with attention to detail and accuracy of fact reporting.
• Demonstrated ability to work with individual from diverse backgrounds.
• Maintain a positive working relationship with CITC staff.
• Must maintain confidentiality at all times while displaying a professional disposition.
• Demonstrated experience working with Alaska Native people, knowledge of their values and belief systems and ability to provide culturally competent services.

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

Minimum Qualifications:

Quality Assurance Specialist I

• Associate’s Degree in Public Health, Human Services, Public Administration, Behavioral Health, or related field.  Relevant experience may substitute for the educational requirement on a year-for-year basis.
• Minimum of one (1) year experience working in healthcare, behavioral health or related field.  
• Minimum of one (1) year experience working with an electronic health record or case management system.
• Minimum of one (1) year experience working with evidence-based practices in a healthcare, behavioral health or related field.

Quality Assurance Specialist II

• Associate’s Degree in Public Health, Human Services, Public Administration, Behavioral Health, or related field.  Relevant experience may substitute for the educational requirement on a year-for-year basis.
• Minimum of two (2) years’ experience working in healthcare, behavioral health or related field.
• Minimum of two (2) years’ experience working in an electronic health record or case management system.
• Minimum of two (2) years’ experience working with evidence-based practices in healthcare, behavioral health or related field.

Quality Assurance Specialist III

• Bachelor’s Degree in in Public Health, Public Administration, Behavioral Health or related field.  Relevant experience may substitute for the educational requirement on a year-for-year basis. 
• Minimum of three (3) years’ experience working in a health care, behavioral health or related field setting as a quality assurance or supervisor position.
• Minimum of three (3) years’ experience working in an electronic health record or electronic case management system.
• Minimum of two (2) years’ experience working with evidence-based practices in healthcare, behavioral health or related field

Minimum Qualifications for all Job Levels:

• Experience working with Alaska Native people, understanding of their values and belief systems, and ability to provide culturally competent services.
• Continued employment is contingent upon completion of a satisfactory state and federal fingerprint criminal background check.
• Ability to work offsite, including computer and internet access.

Physical Requirements:

• Primarily works in an office setting, with extended periods of time at a desk and on a computer. 

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 Native, American Indian (AN/AI) and Native Hawaiian people, including direct lineal descendants and foster or traditionally adopted children. Also included are 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.

1.2.24 KM