Quality Assurance Coordinator

SKIP of New York is a leading not-for-profit organization supporting medically fragile children and youth with a variety of physical and developmental disabilities. Launched over 40 years ago, SKIP believes every child deserves the best childhood they can get.

SKIP connects children/youth with supports they need (like nursing/home care, insurance coverage, DME, supplies, transportation, respite, environmental modifications, grants, etc.) to heal and thrive, living at home with their family rather than in hospitals and institutions. SKIP services allow children to participate in their schools and communities and to realize their full potential.

In the QA position, you will learn a lot and be provided opportunities to hone your organizational style, time-management skills in an organization that encourages teamwork and collaboration.

Qualifications

The Quality Assurance Coordinator position is a multipurpose position requiring at least a Bachelor's Degree in health/human services, education, communications, quality or related field. Minimum of 1 year experience working in human/social service systems supporting children and families with long term, chronic health conditions or developmental disabilities required. Prior Health Home Care Management experience desirable, along with experience in continuous audits, quality improvement initiatives and use of electronic health record systems. Excellent organization, time management and communication skills are essential to the position.

Position Overview

QA Coordinator functions as an important and versatile member of the Health Home Care Management team, responsible for ongoing audits and quality assurance initiatives, with additional responsibilities in support of care management staff and administrative tasks as assigned by Supervisor/Director/VP. The function of Quality Assurance is to ensure the best possible work product for the individuals we support, their families, and the organizations with which we interact. The responsibilities and essential job functions of this position are ever evolving with changing regulatory requirements and program priorities.

Possible duties for Quality Assurance Coordinator position include but are not limited to:

· Conduct comprehensive reviews of client records, both physical and electronic.

· Obtain essential documentation from different governing bodies and collateral contacts.

· Audits: complete audits across caseloads including introductory, full audits, billing, audits of records in process of closure or transition from Health Homes, and external state/OMIG audits.

· Prepare case files to be purged, checked and/or scanned.

· Utilize internal tracking systems to ensure compliance of required eligibility and level of care.

· Support the team to address needs of families served in a consistent and timely manner.

· Update shared lists of resources and agency/provider contact information to be used by staff.

· Develop and implement various trainings as needed, including those on QA and program policies.

· Review and process Child and Adolescent Needs and Strengths (CANS) assessments. Complete Plan of Care, Consent and various programmatic documentation reviews/updates as needed.

· Obtain relevant disability documentation. Process HCBS LOC Eligibility determinations in UAS.

· Support care management staff to maintain neat and presentable physical & electronic case records for each person served, maintaining quality/audit-ready records. Scan and save files to EHR.

· Complete reports and other administrative tasks for Supervisors, Directors and others. Effectively utilize Health Home quality reporting metrics to help guide work flow.

· Submit DSS-5144 disability determination packets to the state and track accordingly, along with following up to obtain SSA, chronic condition and supporting documents to maintain client eligibility.

· Assist Director/VP to document program processes, ensuring all regulations and changes are communicated and shared with staff. Help create and train to policies & procedures as needed.

· Assist the department with additional responsibilities in support of care management staff and administrative tasks as assigned by Supervisor/Director.

· Conduct family satisfaction surveys, relaying feedback and follow-up to appropriate personnel.

· Oversee Gaps in Care and Clinical/Transitions of Care follow-up, sharing relevant guidance with staff.

· Assist with HCBS Referral/Authorization follow-up and Incident Reporting-Tracking. Use of IRAMS.

· Support Care Managers with family/provider follow-up. Model appropriate communication. Attend meetings with clients and families in the community, helping with intakes or other cases in need of temporary coverage as needed. Write case notes for all case related contacts/tasks completed.

Audits of client records may entail the following tasks:

· Review cases in a continual cycle unless instructed to review specific cases.

· Effectively utilize and maintain SKIP, DOH and Health Home QA/Audit Tools.

· Respond to Health Home comprehensive, process audits, quarterly and routine quality checks, taking applicable proactive steps to ensure SKIP continues to pass all Health Home audits.

· Assis with prescribed performance improvement follow-up and issues remediation, and participate in communications with Health Home partners as needed.

· Technical review consists of (a) chart conformity to SKIP/Health Home filing protocol; (b) documentation timeliness; (c) content, active support to move forward client plans of care; (d) review of technical eligibility processes and programmatic issues; (e) review of case management issues; and, (f) review of care management processes.

· Share relevant audit findings with Care Managers and Supervisors. Holding 1:1 meetings with staff to go over audit outcomes and assist with audit follow-up activities as needed.

· Provide training, modeling and shadowing opportunities for staff to help them understand and bolster their ability to achieve quality outcomes for families that meet Health Home standards.

Billing:

In addition to tasks above, Quality Assurance Coordinator may assist with department wide billing:

· Provide ongoing support to care managers and supervisory staff to ensure billing and compliance standards are upheld. Complete and case note billable activities and provide compliance support.

· Check monthly billing for accuracy and ensure all relevant supporting documentation is in order and present in the record.

· Produce billing reports on a monthly basis.

· Provide feedback to supervisors on billing and care management outcomes for appraisal processes.

Additional Position Responsibilities

· Understand and follow all SKIP, DOH, Health Home & program-related policies and procedures.

· Demonstrate professionalism with strong written and verbal communication skills.

· Team-oriented and able to work well with and in support of other team members and with various internal and external personnel.

· Have knowledge of cases and be able to regularly report statuses of audits pending or in progress.

· Maintain CANS-NY certification.

· Satisfy ongoing training requirements. Effectively work within Health Commerce System, Uniform Assessment System, MAPP-Health Home Tracking System, Health Home Care Management electronic health record systems, IRAMS, ePaces, MAS Portal, Tableau, Sharepoint, using various health information technology as required. Complete Health Home and agency-specific trainings as needed.

· Demonstrate strong organizational skills including maintenance of physical/electronic health records.

· Ensure client confidentiality and privacy is maintained.

· Proficient in Microsoft Office Suite including preparing/maintaining spreadsheets.

· Be able to physically handle large case binders.

· Attend regular staff and supervision meetings, presenting relevant topics in meetings.

· Conduct meetings in the community, with potential travel to distant counties and other SKIP offices, visiting homes/sites where animals may be present.

· Assist with various other special projects as assigned.

JOB TYPE: Full-Time, Monday-Friday, Day Shift, 8 Hour shift, Hybrid (for qualified staff)

BENEFITS PACKAGE: Valued at $22,000+

SKIP of New York offers excellent benefits including:

-Medical/Dental insurance with individual plans FULLY COVERED by SKIP (at NO COST to the individual employee)

-Paid Life Insurance. Parental Leave

-Generous paid time off (PTO) in addition to 12 paid Holidays each year

-Flexible work hours

-Mileage Reimbursement

• Opportunities for remote work from home days (up to 2 days per week) for staff who qualify

-Opportunities for growth/advancement and a team based supportive working environment

*Additional information about SKIP and the families we help can be found at

Work Location: Rochester, NY 14624

Job Type: Full-time

Pay: Up to $25.50 per hour

Compensation commensurate with education/experience.

How to apply: Please forward cover letter/resume with salary requirements for consideration. Additional information about SKIP can be found at

Job Type: Full-time

Pay: $ $25.50 per hour

Benefits:

• Dental insurance
• Flexible schedule
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Education:

• Bachelor's (Preferred)

License/Certification:

• Driver's License (Preferred)

Work Location: Hybrid remote in Rochester, NY 14624