Volunteers of America
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at Volunteers of America
PRIMARY RELATIONSHIPS: Executive Director, Center Directors, Medical Records, Center staff members, participants and family members.
OBJECTIVE: Under the supervision of the Director of Quality, develops, organizes and monitors a Quality Assessment and Performance Improvement (QAPI) plan for the Senior CommUnity Care (SCC) program. The Quality Assurance Coordinator is responsible for developing the QAPI annual plan, and guiding the implementation of the plan. Ensuring that data is collected from all appropriate sources; and the data is examined and the results are shared with all stakeholders. Oversees the process to evaluate and resolve medical and non-medical grievances by participants, their family members, or representatives. The Quality Assurance Coordinator acts as the Health Insurance Portability and Accountability Act (HIPAA) Privacy Compliance Officer for Senior CommUnity Care. The Quality Assurance Coordinator is responsible for over sight of the Medical Records and the Compliance Officer to ensure all Centers for Medicare and Medicaid Services (CMS) and State required activities related with these positions.
1. Develops, and guides the implementation of the annual QAPI plan.
2. Ensures staff integration into the QAPI process through Continuous Quality Improvement education and developing opportunities for input.
3. Analyses of risk management data, and QAPI activities data with the objective of identifying and controlling loss to protect the assets of the organization.
4. Conducts annual satisfaction surveys of the participants and caregivers of Senior CommUnity Care and reports findings.
5. Reports data and information in the manner and at the time intervals specified by CMS and the State agency pertaining to participant care activities and outcomes.
6. Facilitates quality assurance-related communication between contract facilities and SCC Interdisciplinary Team and employees.
7. Participates in orientation with contract facilities to ensure effective coordination of participant care, as needed provides scheduled on site inspection of contracted facilities to ensure quality care is provided and compliance with State and CMS regulations
8. Facilitates the quality assurance/performance improvement process for various services areas within Senior CommUnity Care.
9. Oversees the process to evaluate, and resolve medical and non-medical grievances by participants, and or their representatives, ensures information is reviewed for incorporating issues in development of Quality Improvement Initiatives and annual QAPI plan.
10. Attends the Participant Advisory Committee, assists in development of agendas, and acts as meeting facilitator.
11. Acts as Senior CommUnity Care HIPAA compliance officer. Provides initial training to new hires, and ongoing training to existing staff.
12. Develops and implements all policies and procedures related to HIPAA regulations.
13. Participates and offers direction across PACE departments concerning questions and all activities interfacing with HIPAA rules and requirements.
14. In conjunction with the Executive Director has overall responsibility for Senior CommUnity Care's Emergency/Disaster planning, training and implementation.
15. In conjunction with the Contract and Credentialing Coordinator ensures all Senior CommUnity Care business relationships, and contracts are HIPAA compliant.
16. Assumes overall accountability of the Medical Records and Compliance departments to ensure practices are in compliance with State Agencies and CMS.
17. Ensures that the job responsibilities, authorities and accountability of all direct reports are defined and understood.
18. Protects privacy and maintains confidentiality of all company procedures, results and information about employees, participants and families.
19. Practices Universal Precautions and follows all appropriate infection control procedures.
20. Participates in continuing education classes and any required staff and training meetings.
21. Performs relates duties as required or requested.
QUALIFICATIONS: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
1. Must have a valid driver's license, proof of insurance and have means of transportation.
2. Education: Minimum of Bachelor's Degree in health-related field or three (3) years of relevant experience in health-related field.
3. Experience: Minimum of four (4) years of demonstrated experience in QAPI activities in a health-related work environment.
4. Skills and Knowledge:
- Ability to lead and supervise effectively.
- Creative, detailed-oriented and organized.
- Excellent written and verbal communication skills with specific ability to maintain accurate records.
- Ability to facilitate effective meetings.
- Excellent customer service skills.
- Must have integrity, practice discretion and practice objective problem solving.
- Data collection skills and knowledge of basic statistical principles.
- Skilled in establishing and maintaining effective working relationships with participants, co-workers, medical staff, and the public.
- Skilled in identifying and recommending problem resolution.
- Ability to utilize computers and other electronic devices for tasks such as timekeeping, in-servicing and documentation.
The work environment characteristics described here are representative of those an employee may encounter while performing the essential functions of this job. Reasonable accommodations may be made to enable individual with disabilities to perform the essential functions:
1. May be exposed to a risk through contact with toxic substances, communicable diseases and any other conditions common in a health care environment.
2. Subject to unpleasant odors.
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individual with disabilities to meet these demands:
1. Physical Requirements - Requires standing, walking, occasional pushing and pulling and lifting. Requires the ability to lift/carry up to fifty (50) pounds and push or pull objects exceeding one hundred fifty (150) pounds, using appropriate body mechanics. Requires manual and finger dexterity and eye-hand coordination. Must be able to document care provided in participants' service records. Must be able to communicate verbally with participants their treatment plan, team members and participants caregivers.
2. Visual, Hearing and Communication Requirements - Requires corrected vision and hearing to normal range, with or without reasonable accommodation. Must be able to communicate verbally with all staff, caregivers, participants, and community at large.
3. Pressure Factor - Requires working under stressful conditions. Working conditions may be noisy and crowded and fluctuating indoor temperatures. Moderate pressure to meet scheduled appointments while dealing with frail and confused participants. Subject to participants that may have the potential for verbal or physical aggression.