IRIS Quality Program Specialist

The Quality Program Specialist is a key position within the Include, Respect, I Self-Direct (IRIS) program, a major Medicaid-funded initiative in Wisconsin that provides long-term care to adults with disabilities and the frailties of aging. This role is responsible for the development, implementation, and oversight of the programs quality management plan to ensure participants receive high-quality, person-centered, and self-directed care.

Responsibilities

• Quality Management: Develop and implement the IRIS quality management program, ensuring it aligns with federal and state requirements, including CMS Assurances and DHS contract stipulations. You will conduct regular reviews, analyze data for performance measurement and quality improvement, and identify trends in critical incidents to prevent future occurrences. This includes managing corrective action plans and ensuring proper implementation of restrictive measures.
• Program Integrity and Issue Resolution: Investigate and resolve participant-specific issues, complaints, and appeals. Youll track progress toward resolution, collaborate with contracted agencies, and analyze individual situations to identify systemic trends. This role is critical for ensuring program integrity and mitigating risk.
• Communication and Training: Serve as a subject matter expert, providing technical assistance to contractors, vendors, and other stakeholders on program requirements, policies, and operational issues. You will prepare and present materials on program-related topics, facilitate system improvements, and foster cooperation among internal and external entities. You will also develop and deliver training on federal and state requirements.
• Oversight and Analysis: Continuously oversee the quality management plan, ensuring that all entities meet established standards and performance expectations. This includes participating in the development of systems for monitoring health and safety issues, critical incidents, grievances, and appeals. You will also conduct analyses and studies to identify, develop, and implement performance improvement projects.
• Special Assignments: Represent the department at meetings, conferences, and workshops with long-term care industry representatives and special interest groups. You will also complete special assignments as requested by leadership.
  
  

Qualifications

• Expert Knowledge: Extensive knowledge of the principles of self-determination, care management, and long-term care delivery systems for frail elders and adults with disabilities. This includes a deep understanding of state and federal statutes, regulations, policies, and procedures governing the Medical Assistance program.
• Quality and Analytical Skills: Proven experience with quality improvement and assurance methods, strong analytical skills, and a keen attention to detail.
• Communication and Interpersonal Skills: Excellent verbal, written, and listening communication skills. The ability to provide difficult feedback, facilitate resolutions, and build strong relationships with a diverse group of people is essential.
• Problem-Solving: The ability to think critically, creatively, and proactively to solve problems.
• Flexibility and Independence: The ability to work both independently and as part of a team, with a self-motivated and adaptable mindset.
• Technical Proficiency: Demonstrated computer skills, with proficiency in Microsoft Office Suite.
• Travel: Ability to travel within Wisconsin and other states as necessary. A valid drivers license and adequate auto insurance are required.
• Required: Reside in Wisconsin; Bachelors Degree
  
  

Please apply for immediate consideration!

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