Compliance and Quality Assuance Specialist

Quality Assurance Specialist

Lead with Purpose and Elevate Quality Across Every Program

At Grafton Integrated Health Network were committed to ensuring individuals with complex needs receive the highest-quality support. As a Quality Assurance Specialist you play a key role in maintaining excellence by reviewing documentation monitoring compliance and partnering with teams to strengthen service delivery. Youll help foster a culture of accountability and continuous improvement providing clear feedback and guidance that supports both staff and the individuals we serve. And because we invest in those who drive our mission forward Grafton provides the tools and professional development you need to grow while making a meaningful impact.

Join us - and experience the deep fulfillment of knowing your work truly makes a difference!
Be part of a team that leads with heart and grit the Grafton waywhere leadership compassion and dedication come together to change lives.

The QA Specialist promotes and ensures protections of client rights; conducts investigations into allegations of abuse or neglect; supports activities to ensure compliance with regulatory and accrediting agencies; engages in activities to support the assigned region in continuous quality improvement initiatives; works collaboratively with other Quality Assurancepartners to coordinate department activities.

Essential Job Functions

• Conducts activities to assure regional compliance with applicable regulatory standards such as Virginias Department of Education (DOE) Department of Behavioral Health and Developmental Services (DBHDS)as well as contract requirements and payor stipulations.Serves as on-site resource for questionspertaining toregulatory compliance; Supports preparation activities for licensing surveys and supports activities duringrelated external reviews;Maintainscopies of licenses required by state and local government.
• Conducts activities to assure compliance with all applicable Medicaid requirements such as those related to service delivery therapeutic passes client record documentation and external reportingActivities include conducting qualitative and quantitative auditsmonitoringdatapreparinganddisseminatingdata reports for management use.Stays current with relevant Medicaid changes and serves as point of contact for related questions from others and discussions of methods for assuring ongoing compliance.
• Conducts activities to assure regional compliance with applicable accreditation standards such as CARF; Serves as on-site resource for questionspertaining toaccreditation compliance; Supports preparation activities for accreditation surveys andfacilitateson-site visits by accrediting body;Maintainscopy of accreditation on-site.
• Conducts audits as assigned to support regional and organization continuous quality improvement processes.Audits may involve clientdocumentationphysicalenvironments employee training/qualifications.Provides audit findings to Executive Director and Quality Assurance Director and monitors for completion of follow up actionsidentified. Produces data reports as requested by the Director Quality Assurance and Compliance or Executive Director.
• Operates within the organizations electronic client record (ECR) by conducting audits of information/documentation entered by generating and analyzing data reports produced through theECR andmayparticipatein thedevelopment and training process for ECR use.
• Facilitates development ofinternal and externalcorrective action plans and monitors implementation of corrective action plans; provides status reports asrequested to the Director Quality Assurance and Compliance and Executive Director.
• Acts as an objective party to hear concerns or complaints about alleged human rights violations; Investigates andfacilitatesresolution; Reports complaints as necessary to regional human rights advocate andfacilitatesexternal review of such matters; Provides Director Quality Assurance and Compliance with such data including resolution.
• Assures protection of clients human rights through activities such as review of proposed restrictions consideration of program guidelines and activitiesmonitoringuse of pat downs and property searches and ongoing monitoring of implemented environmental/individual restrictions.
• Receives reports of alleged abuse or neglect; Notifies Department of Social Services and licensing bodies of allegations of abuse or neglect; Coordinates investigations with external agencies; Conducts internal investigations; Prepares report of investigation findings and makes recommendations for corrective action.
• Receives andmaintainscopies of Serious Incident Notification forms; Ensures processing occurs of serious incidents with corrective action plans as needed; Produces aggregate data reports of regional serious incidents andsubmitsreports to Director Quality Assurance and Compliance regional management team and Executive Director.
• Makes external notifications of certain serious incidents asneeded for compliance withregulatory standardsand payor requirements.This may involveuseof external electronic systems.Conducts investigations into specific incidents andsubmitswritten reports toexternal entities as.
• May supervise one or more employees assuring training development and personnel needs are met for those individuals.
• Works in partnership with other Quality Assurance Supervisors to assure efficiency and effectiveness in fulfilling responsibilities.
• Provides employeeand clienttrainingon human rights related issues.
• Provides employee training on regulatory compliance Medicaid complianceandpolicies and proceduresas requested.
• Acts as resource to program managers in developing strategies for dealing with high-risksituations.
• Performs otherdutiesassigned.

MINIMUM QUALIFICATIONS

• Requires a Bachelors degree in a related field and a minimum of two years related experience providing and reviewing services investigating allegations of client abuse and neglect leading quality improvement initiatives or interpreting and applying licensure standards to human services programsOR
• HS/equiv. and a minimum of fiveyears experiencein the human services field with at least two years providing and reviewing services investigating allegations of client abuse and neglect leading quality improvement initiatives or interpreting and applying licensure standards to human services programs.
• Requires a valid driverslicense.
• Requires a working knowledge of applicableregulations.
• Completion of all requiredtrainings.Maintains all required annual certifications.

EMPLOYEE BENEFITS:

Caring for You So You can Care for Others:

• Medical dental and vision
• Flexible Spending & Health Savings Accounts
• Generous Paid Time Off plan & attendance incentives
• Employer Paid Life Insurance
• Employee Assistance Program (EAP)
• Short-term disability (STD)
• Long-term disability (LTD)

Stronger Together: Supporting Your Growth & Success:

• Paid Career Development - we pay you while becoming certified in CPR Ukeru Mandt and other career training!
• 401(k) including an employer match up to $2500 annually
• Education Assistance up to $5250 annually
• As Grafton is a 501(c)(3) non-profit you may be eligible for federal student loan forgiveness

If you have issues applying or have any questions about this position please reach out to us at

Grafton is an equal employment opportunity employer and tobacco-free workplace.

#LP

Required Experience:

IC