Quality Assurance Department Manager

This a Philippine-based position;

NOT a US based position and the pay rate is not in US currency.

ABOUT FREEDOM HEALTH SYSTEMS INC.:

Freedom Health Systems Inc. is a mission-driven healthcare advisory and management consulting firm that partners with behavioral health and human services organizations to improve access equity and operational excellence. We specialize in guiding providers through program development accreditation compliance and clinical best practicesempowering them to deliver high-quality person-centered care to their communities.

While we do not provide direct healthcare services Freedom Health Systems plays a vital role behind the scenes by strengthening organizational infrastructure supporting service expansion and helping our partners lead with innovation and integrity. Our expertise spans a wide range of operational services including revenue cycle management prior authorization virtual front office support medical billing and coding human resources and compliance consulting.

At Freedom Health Systems we are deeply committed to breaking down barriers in the behavioral health space with a particular focus on serving marginalized and underserved populations. Our team fosters a collaborative forward-thinking work environment where every employee contributes to advancing impactful community-based care.

DISCLOSURES:

The specific statements shown in each section of this job description are not intended to be all-inclusive. They represent typical elements and criteria considered necessary to perform the job successfully. The jobs responsibilities/tasks may be modified and/or expanded over time. Company will inform the personnel member when changes in the respective job description are made.

COMPANY WEBSITE:

COMPANY PHONE NUMBER:

HUMAN RESOURCES DEPARTMENT PHONE NUMBER: EXT 10

HUMAN RESOURCES DEPARTMENT EMAIL ADDRESS:

POSITION TITLE: Quality Assurance Department Manager

ALTERNATE TITLE(S):

COMPANY: Freedom Health Systems Inc. (in support of all customer companies under contract)

DIVISION: Accounting & Finance

DEPARTMENT: Medical Records Quality Assurance

UNIT: n/a

BENEFITS PACKAGE: Ineligible

WORK SCHEDULE: Monday Friday 8:00 AM 5:00 PM

ACCOUNTABLE TO: Controller or Chief Financial Officer (CFO in absence of Controller)

ACCOUNTABLE FOR: All staff responsible for reviewing documentation of services for compliance with internal medical record checklists and overseeing medical records request processing

CLASSIFICATION: W8BEN; hourly contractual

COMPENSATION RANGE: 482.16 PHP per hour (this is not USD)

ANTICIPATED TRAVEL: none

SUMMARY OF POSITION RESPONSIBILITIES:

The Quality Assurance Department Manager is responsible for overseeing all service record quality assurance and compliance activities for the programs Freedom Health Systems contractually supports. The QA Manager ensures all services meet regulatory and contractual obligations including those outlined by COMAR CARF OHCQ MDH and managed care organizations by applying checklist guidelines to each note entered by rendering providers.

This role manages the quality monitoring process leads internal audits oversees documentation standards and works in collaboration with program leadership to implement quality improvement strategies and correct deficiencies. The QA Manager is also responsible for ensuring that documentation of services entered by service providers aligns with the companys required medical record addition the role oversees the process for handling medical records requests in accordance with privacy regulations and organizational policy.

SCHEDULED DUTIES AND RESPONSIBILITIES:

• Supervise daily QA operations and staff including auditors file reviewers and compliance specialists
• Monitor program compliance with COMAR CARF CSA OHCQ HIPAA and other applicable standards
• Oversee documentation review to ensure that records entered by service providers meet organizational checklist requirements
• Maintain audit schedules workflows and documentation templates across programs
• Conduct internal audits of clinical administrative and billing records to assess compliance
• Develop and distribute monthly QA reports and dashboards for executive review
• Maintain regulatory readiness through ongoing mock audits and staff education
• Collaborate with program managers and clinical directors to review findings and implement corrective action plans (CAPs)
• Manage incident reporting workflows and documentation
• Coordinate and support external audits surveys and licensing visits
• Update policies and procedures in collaboration with leadership and regulatory updates
• Ensure orientation and re-orientation of staff on QA policies documentation standards and reporting responsibilities
• Provide coaching support and education to departments around best practices and documentation expectations
• Ensure confidentiality security and auditability of all QA documentation
• Oversee intake and fulfillment of internal and external medical records requests ensuring compliance with HIPAA and legal timelines

UNSCHEDULED DUTIES AND RESPONSIBILITIES:

• Serve as point of contact for payables escalations and internal/external stakeholder inquiries
• Take initiative to identify areas for process improvement and cost savings
• Assist with special projects vendor transitions and system implementations as assigned
• Participate in interdepartmental workgroups focused on performance improvement or new service lines
• Assist your supervisor with any work-related tasks as requested taking initiative where possible
• Remain informed and compliant with regulations and standards including COMAR CARF and other relevant governing bodies as well as company policies and procedures
• Co-facilitate orientation of new hires related to documentation payables procedures and compliance requirements
• Support the maintenance of a safe work environment by participating in drills and safety trainings as requested
• Maintain confidentiality of all records especially those relating to client treatment or financial information
• Participate in external and internal audits/surveys (CARF/CSA/OHCQ) as directed by the supervisor
• Support credentialing and licensure renewals by compiling and submitting QA documentation
• Respond to compliance inquiries from staff or leadership
• Participate in emergency response and risk mitigation planning
• Represent the QA department at leadership meetings cross-functional committees and community forums as assigned
• Coordinate ongoing quality improvement initiatives aligned with strategic goals and funding requirements

PHYSICAL DEMANDS:

• Prolonged periods sitting at a desk and working on a computer
• Occasional lifting up to 25 pounds
• Frequent meetings via video or phone; occasional in-person site visits

WORKING CONDITIONS:

• On-site only
  
• Office-based with travel between program sites as needed

COMPETENCIES AND SKILLS:

• Comprehensive knowledge of QA/QI systems audits and performance improvement planning
• Familiarity with Maryland healthcare regulations and behavioral health standards
• Proficiency with EHR systems Excel and quality tracking tools
• Excellent analytical communication and organizational skills
• Ability to interpret regulations and translate them into clear workflows and documentation
• Strong leadership training and problem-solving abilities
  

LEVEL OF EDUCATION / TRAINING / QUALIFICATIONS:

• Bachelors degree in Healthcare Administration Public Health Social Work Nursing or related field (required); Masters preferred
• Minimum 35 years of experience in healthcare quality assurance or compliance
• At least 12 years of supervisory or management experience
• Knowledge of COMAR CARF HIPAA Medicaid and managed care standards
• Experience in behavioral health or human services preferred
• Ability to pass background and reference checks
• Certified Professional Medical Auditor (CPMA) certification
  

Required Experience:

Manager