What are the responsibilities and job description for the Quality Assurance Manager position at Health Management Systems of America?
Job Summary
We are seeking a highly skilled and detail-oriented Quality Assurance Manager to oversee and enhance our quality management systems. The ideal candidate will possess extensive knowledge of regulatory requirements. As a pivotal member of our team, you will lead quality assurance initiatives, conduct comprehensive quality audits, and ensure compliance with all applicable standards to uphold the highest levels of safety, efficacy, and customer satisfaction. Your leadership will drive continuous improvement in quality control processes and foster a culture of excellence throughout the organization.
Responsibilities
- Quality Assurance Coordinator
- Employment Type: Full-Time with benefits
- Minimum Qualifications
- Batchlor's degree in social work, psychology, healthcare administration, public health, or related field.
- At least 3 years of experience in quality improvement, compliance, or program evaluation.
- Preferred Qualifications
- Licensed professional (LMSW, LPC, LP, or similar).
- Certified Professional in Healthcare Quality (CPHQ) or similar certification.
- Knowledge of CARF accreditation standards and behavioral health regulations.
- Experience working with federally funded programs (Medicaid, grants, or PIHP systems).
- Strong organizational, analytical, and communication skills.
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- Work Setting
- Hybrid 3 days in office with 2 days remote.
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- Duties
- 1. This position monitors service delivery, documentation, and operational processes to ensure quality of care, regulatory compliance, and continuous performance improvement.
- 2. Leads internal audits, performance improvement initiatives, risk management activities, and prepares the organization for CARF surveys and external audits.
- 3. Oversees continuous quality improvement (CQI) activities and performance measurement systems.
- 4. Collects, analyzes, and reports data related to program effectiveness, service outcomes, and stakeholder satisfaction.
- 5. Monitors key performance indicators (KPIs) and quality metrics required by federal funding sources and payers.
- 6. Coordinates CARF survey preparation, documentation review, and corrective action planning.
- 7. Provides guidance and training to staff.
- 8. Oversees quarterly quality record reviews of open and closed clinical records.
- 9. Monitors compliance with PIHP, Medicaid, and federal documentation standards.
- 10. Investigates quality concerns, complaints, and critical incidents.
- 11. Oversees collection and analysis of:
- a. Outcome measures
- b. Service utilization data
- c. Satisfaction surveys
- d. Incident reports
- 12. Prepare quarterly and annual quality reports for leadership.
- 13. Ensures policies align with:
- a. CARF accreditation requirements
- b. Federal regulations
- c. State licensing standards
Equal Opportunity Employer Statement
HMSA is an equal opportunity employer and are committed to creating an inclusive environment for all employees. We do not discriminate on the basis of race, color, religion, sex, gender identity or expression, sexual orientation, national origin, genetics, disability, age, veteran status, or any other protected characteristic in accordance with applicable federal, state, and local laws.
Pay: $62,646.73 - $75,445.53 per year
Work Location: In person
Salary : $62,647 - $75,446