What are the responsibilities and job description for the PCM Evaluation Department- Quality Assurance and Assistant Scheduler position at Tempus Unlimited, Inc.?
PCM Evaluation Department -Quality Assurance and Assistant Scheduler Summary/Objective: This position is part of our PCA program at Tempus Unlimited. This position supports the Personal Care Management (PCM) evaluation team with, quality assurance, scheduling initial and re-evaluations. Primary role is to execute daily Quality Assurance (QA) workflows for MassHealth Personal Care Attendant (PCA) evaluations, verify system data accuracy, and maintain consumer records prioritize appointments via date ranges, organize geography, and communicate with internal clinical staff of RNs and OTS, facilities, and consumers/ surrogates. Must be able to manage electronic calendar appointments, and various forms of communication effectively and efficiently. Essential Functions Perform mandatory daily audits of RN and OT digital folders to ensure all newly submitted MassHealth PCA evaluations are captured and processed immediately.
Verify and log evaluation receipt dates into the Zuke system daily
Actively review paperwork for completeness; directly communicate with clinicians (RNs/OTs) if documentation is missing, incomplete, or requires corrections before submission.
Coordinate directly with the Prior Authorization (PA) department to formally communicate when audited evaluations are completely accurate and ready for final submission.
Assign initial evaluations to a Registered Nurse (RN)/Licensed Practical Nurse (LPN) and Occupational Therapist (OT) team
Schedule Initial evaluations with consumer/surrogate
Schedules for re-evaluations as needed.
Outreach to those who are “On Hold” to stay up to date of their resumption of the program.
Enter evaluation time, date and location on initial calendar and duplicate info on each RN and OT personal schedule calendar. Add re-evals to the calendar as needed.
Call consumer/surrogate daily to confirm evaluations scheduled for the next day
Communicate with evaluation teams of any changes to their schedules due to cancelations etc. noting all changes on initial calendar for tracking, add progress note in Zuke database.
Create Electronic folder for all initial evaluations with adding all required and applicable documents
Create a Monthly Initial Calendar for evaluation scheduling after input of time off requests. Duplicate info on all RN and OT calendars
Weekly Tracking Report of initial status for Department Manager
Document a progress note for all calls, email, or other communication in Zuke.
Other duties as assigned. Competencies Computer skills- MS Word, Excel
Good written and verbal skills
Strong organizational skills
Accuracy and attention to detail
Ability to multitask
Adaptability/flexibility
Self-motivated
Perform all other duties as may be required. Required Experience Previous administrative support experience Required Education High School Diploma Work Environment This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers and scanners. Physical Demands 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.
While performing the duties of this job, the employee is regularly required to talk and/or hear. The employee is frequently required to sit; stand; walk; use hands and fingers and also must be able to reach with hands and arms.
lift, push, pull up to ten to fifteen pounds
communicate with consumers and coworkers Travel No travel is required for this position. Other Duties
Note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice. Communicate with internal clinical staff of RNs and OTS, facilities, and consumers/ surrogates. Must be able to manage electronic calendar appointments, and various forms of communication effectively and efficiently. Essential Functions Assign initial evaluations to a Registered Nurse (RN) and Occupational Therapist (OT) team
Schedule Initial evaluations with consumer/surrogate
Schedules re-evaluations as needed.
Outreach to those who are “On Hold” to stay up to date of their resumption of the program.
Enter evaluation time, date and location on initial calendar and duplicate info on each RN and OT personal schedule calendar. Add re-evals to the calendar also as needed.
Call consumer/surrogate daily to confirm evaluations scheduled for the next day
Communicate with evaluation teams of any changes to their schedules due to cancelations etc. noting all changes on initial calendar for tracking, add progress note in Zuke database.
Create Electronic folder for all initial evaluations with adding all required and applicable documents
Create a Monthly Initial Calendar for evaluation scheduling after input of time off requests. Duplicate info on all RN and OT calendars
Weekly Tracking Report of initial status for Department Manager
Document a progress note for all calls, email, or other communication in Zuke.
Other duties as assigned. Competencies Computer skills- MS Word, Excel
Good written and verbal skills
Strong organizational skills
Accuracy and attention to detail
Ability to multitask
Adaptability/flexibility
Self-motivated
Perform all other duties as may be required. Required Experience Previous administrative support experience Required Education High School Diploma Work Environment This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers and scanners. Physical Demands 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.
While performing the duties of this job, the employee is regularly required to talk and/or hear. The employee is frequently required to sit; stand; walk; use hands and fingers and also must be able to reach with hands and arms.
lift, push, pull up to ten to fifteen pounds
communicate with consumers and coworkers Travel No travel is required for this position. Other Duties
Note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.
Verify and log evaluation receipt dates into the Zuke system daily
Actively review paperwork for completeness; directly communicate with clinicians (RNs/OTs) if documentation is missing, incomplete, or requires corrections before submission.
Coordinate directly with the Prior Authorization (PA) department to formally communicate when audited evaluations are completely accurate and ready for final submission.
Assign initial evaluations to a Registered Nurse (RN)/Licensed Practical Nurse (LPN) and Occupational Therapist (OT) team
Schedule Initial evaluations with consumer/surrogate
Schedules for re-evaluations as needed.
Outreach to those who are “On Hold” to stay up to date of their resumption of the program.
Enter evaluation time, date and location on initial calendar and duplicate info on each RN and OT personal schedule calendar. Add re-evals to the calendar as needed.
Call consumer/surrogate daily to confirm evaluations scheduled for the next day
Communicate with evaluation teams of any changes to their schedules due to cancelations etc. noting all changes on initial calendar for tracking, add progress note in Zuke database.
Create Electronic folder for all initial evaluations with adding all required and applicable documents
Create a Monthly Initial Calendar for evaluation scheduling after input of time off requests. Duplicate info on all RN and OT calendars
Weekly Tracking Report of initial status for Department Manager
Document a progress note for all calls, email, or other communication in Zuke.
Other duties as assigned. Competencies Computer skills- MS Word, Excel
Good written and verbal skills
Strong organizational skills
Accuracy and attention to detail
Ability to multitask
Adaptability/flexibility
Self-motivated
Perform all other duties as may be required. Required Experience Previous administrative support experience Required Education High School Diploma Work Environment This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers and scanners. Physical Demands 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.
While performing the duties of this job, the employee is regularly required to talk and/or hear. The employee is frequently required to sit; stand; walk; use hands and fingers and also must be able to reach with hands and arms.
lift, push, pull up to ten to fifteen pounds
communicate with consumers and coworkers Travel No travel is required for this position. Other Duties
Note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice. Communicate with internal clinical staff of RNs and OTS, facilities, and consumers/ surrogates. Must be able to manage electronic calendar appointments, and various forms of communication effectively and efficiently. Essential Functions Assign initial evaluations to a Registered Nurse (RN) and Occupational Therapist (OT) team
Schedule Initial evaluations with consumer/surrogate
Schedules re-evaluations as needed.
Outreach to those who are “On Hold” to stay up to date of their resumption of the program.
Enter evaluation time, date and location on initial calendar and duplicate info on each RN and OT personal schedule calendar. Add re-evals to the calendar also as needed.
Call consumer/surrogate daily to confirm evaluations scheduled for the next day
Communicate with evaluation teams of any changes to their schedules due to cancelations etc. noting all changes on initial calendar for tracking, add progress note in Zuke database.
Create Electronic folder for all initial evaluations with adding all required and applicable documents
Create a Monthly Initial Calendar for evaluation scheduling after input of time off requests. Duplicate info on all RN and OT calendars
Weekly Tracking Report of initial status for Department Manager
Document a progress note for all calls, email, or other communication in Zuke.
Other duties as assigned. Competencies Computer skills- MS Word, Excel
Good written and verbal skills
Strong organizational skills
Accuracy and attention to detail
Ability to multitask
Adaptability/flexibility
Self-motivated
Perform all other duties as may be required. Required Experience Previous administrative support experience Required Education High School Diploma Work Environment This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers and scanners. Physical Demands 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.
While performing the duties of this job, the employee is regularly required to talk and/or hear. The employee is frequently required to sit; stand; walk; use hands and fingers and also must be able to reach with hands and arms.
lift, push, pull up to ten to fifteen pounds
communicate with consumers and coworkers Travel No travel is required for this position. Other Duties
Note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.