Quality Assurance Reviewer
Quality Assurance Reviewer
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Job Description
Qlarant is a not-for-profit corporation that partners with public and private sectors to create high quality safe and efficient delivery of health care and human services programs. We have multiple lines of business including population health utilization review managed care organization quality review and quality assurance for programs serving individuals with developmental disabilities. Qlarant is also a national leader in fighting fraud waste and abuse for large organizations across the addition our Foundation provides grant opportunities to those with programs for under-served communities.
Best People Best Solutions Best Results
Job Summary:
Facilitates routine evaluations to assess the extent to which individuals with intellectual developmental disabilities (IDD) are receiving customized support and services tailored to their unique needs and specific situations. Performs scheduled reviews to assess how effectively IDD service providers are in preserving the health and safety of the individuals in their care. Assists management in identifying areas for improvement in service delivery providing technical assistance generating meaningful recommendations and collaborating with service providers to execute continuous improvements that meet the needs of individuals with developmental disabilities.
Essential Duties and Responsibilitiesinclude the following. Other duties may be assigned.
- Administers detailed evaluations of programs and service providers to assess their effectiveness and adherence to established standards.
- Ensures that programs comply with relevant laws regulations and policies related to developmental disabilities.
- Determines areas for improvement in programs and services and works with stakeholders to implement quality enhancement initiatives.
- Inspects documentation reports and records to providers to ensure that their needs are met in a respectful and prudent manner.
- Advocates for the rights and well-being of individuals with developmental disabilities and ensures that their needs are met in a respectful and person-centered manner.
- Analyzes data related to program outcomes client satisfaction and other relevant metrics to inform decision-making and continuous improvement efforts.
- Communicates with service providers agencies and stakeholders involved in providing services to individuals with developmental disabilities.
- Develops and provides technical assistance training and guidance to staff and service providers on best practices quality standards and compliance requirements.
- Exercises professional judgment and takes immediate action in the case of abuse neglect and/or exploitation by following established protocols.
- Conducts interviews with individuals receiving services and provider staff in a respectful manner.
- Documents accurate review findings and generates reports based on the results.
Required Skills
To perform the job successfully an individual should demonstrate the following competencies:
- Business Expertise - Basic understanding of how own department integrates within the Business Area.
- Problem Solving - Uses judgment based on the analysis of information.
- Nature of Impact - Direct impact by ensuring the quality of the tasks/services/information provided by self and others.
- Area of Impact - Primarily on an department.
- Interpersonal Skills - Developed communication and diplomacy skills used to direct/persuade/influence others.
- Leadership - Mentors junior team members.
- Functional Knowledge - In-depth understanding of concepts and principles in own discipline and basic knowledge of these elements in other disciplines.
- Project Management - Senior project/program team member responsible for work flow which is varied in nature with situations frequently requiring new solutions.
Employment Type
Full-Time
