Quality Review Technician (ID124)

The Quality Review Technician is responsible for conducting quality assurance functions, compliance audits, and ensuring the accuracy and completeness of documentation. This position reviews medical records, ensuring compliance with regulatory standards and policies. The Quality Review Technician also compiles and submits documentation for internal and external stakeholders, which may include but are not limited to audits and reviews, while ensuring that Agency goals and regulatory requirements are consistently met.

This job description is based upon an evaluation of agency requirements at the time this description was written. This job description will change as the position is developed further, or in response to organizational or technological changes.

MAJOR DUTIES AND RESPONSIBILITIES:

• Review medical records for quality review and quality improvement (QI) purposes, completing chart review forms to ensure compliance with regulatory standards and policies.
• Distribute completed QA Chart Reviews to supervisors monthly, communicating all medical record deficiencies as appropriate.
• Attend Clinical Quality Review Committee meetings as required, communicate the agenda, and keep record of the minutes and any documents submitted by committee members into the minutes.
• Analyze chart review results and reports to assist with identifying trends and deficiencies.
• Assist with the maintenance of the QI Plan to include the adoption, implementation, and monitoring of agency goals and objectives.
• Assist with audits and compliance reviews by external entities, including inputting required information into various systems or gathering requested documents and reports as needed
• Escalates complex / system discrepancies as appropriate for further review and resolution.
• Maintain working knowledge of ROI (Release of Information) processes and provide back-up to QA Tech as needed. This includes communicating with clinicians on an “as needed” basis when requests are pending due to incomplete records.
• Monitor Intellectual and Developmental Disability (ID/DD) service authorizations (SA) and individual service plans (ISP) in WaMS, reminding case managers of due tasks and assigning cases as needed.
• Assists with the creation of case manager profiles, training, and the reviewing of reports from the Department of Behavioral Health and Developmental Services (DBHDS).
• Acts as the waiver provider for the agency in WaMS and facilitates the interagency process.
• Collaborates to prepare packets for client transfers between Community Services Boards (CSBs) following the DD Services transfer protocol, creating EHR charts for incoming transfers, uploading documentation, and ensuring clear communication regarding transfers.
• Performs related duties as required or deemed appropriate to the accomplishment of the responsibilities and functions related to this position or in support of departmental and Agency goals.

QUALIFICATIONS:

• A combination of education and experience and training that demonstrates the ability to effectively perform essential job functions.
• High School Diploma or GED Required.
• Must possess a valid Driver’s License, good driving record and the ability to provide own transportation.

ADDITIONAL REQUIREMENTS:

• May be exposed to allergenic environments in client’s homes, including extreme heat, humidity, dust, smoke, pet contamination, cleaning supplies, etc.
• Prolonged periods sitting at a desk and working on a computer.
• Must be able to lift/push/pull up to 25 pounds at times.

SALARY: $40,892 – $48,565

POSITION: ID124

RETIREMENT: NWCSB participates in Virginia Retirement System.

DISCLAIMER: All full-time employees are eligible for a complete benefits package that includes enrollment in Virginia Retirement System. For more information about benefits and a complete list of current job openings, please visit our website, www.nwcsb.com. Positions remain open and advertised until filled.

If you need assistance or an accommodation to apply or interview, contact Human Resources at [email protected] or 540-636-4250, Ext 2155.

Northwestern Community Services Board provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.