Quality Assurance Specialist

Job Title: Quality Assurance Specialist Salary Range: $25-31 Reports To: Quality Assurance Director Job Status: Exempt Non-Exempt Summary It is the responsibility of the Quality Assurance Specialist to assemble assigned departmental reports and documentation related to quality management and performance improvement activities within the Centers for Disease Control, any State, and Federal requirements. The Quality Assurance Specialist works with the Quality Improvement, Compliance and Risk Departments to plan, organize, and assist the quality improvement process. This role involves developing, implementing, and monitoring quality assurance processes to maintain compliance with relevant regulations and standards in the Medical and Dental fields. Tiers Tier 1 Entry-level professional with limited or no prior experience; learns to use professional concepts to resolve problems of limited scope and complexity; works on developmental assignments that are initially routine in nature, requiring limited judgment and decision making. Knows fundamental concepts, practices and procedures of field. Tier 2 Professional with 3-5 years of experience and proficient in EMR (such as NextGen, Epic, eClinicalWorks, etc.). Applies acquired job skills, policies, and procedures to complete substantive assignments/projects/tasks of moderate scope and complexity; exercises judgment within defined guidelines and practices to determine appropriate action. Tier 3 Professional with 5 or more years of experience and proficient in EMR (such as NextGen, Epic, eClinicalWorks and etc.) Knows how to apply theory and put it into practice with in-depth understanding of the professional field; independently performs the full range of responsibilities within the function; possesses broad job knowledge; analyzes problems/issues of diverse scope and determines solutions Responsibilities Develop and implement quality management systems to ensure compliance with regulatory requirements, standards, and company policies. Conduct internal audits and assessments to evaluate compliance with quality standards, procedures, and regulations (Monthly Internal Chart Audit Review (Medical and Dental) & Facility Site Visits, among others). Maintain current copies of clinical staff credentials to present during audits. Collaborate with cross-functional teams to identify quality issues, root causes, and corrective actions. Review and interpret regulatory guidelines, standards, and requirements to ensure alignment with organizational practices. Provide guidance, in-person and remote training to employees on quality assurance procedures and requirements; maintain a tracking system for all performed training. Attend department meetings when required. Participate in the development and revision of quality policies, procedures, and documentation. Monitor and analyze quality data and metrics to identify trends, opportunities for improvement, and areas of non-compliance. Coordinate and support external audits and inspections by regulatory agencies or Health Management Organizations (Site Visits and Medical Record Reviews). Stay current with developments in quality management, regulatory requirements, and industry best practices. Assist the Compliance Department with any NCQA and State licensing activities whenever requested. Works after-hours when requested. Participate as an active member of the Infection Control Committee by attending meetings and performing training for on-boarding employees, annually and when requested by supervisor, accordingly. Manages 340B orders and ensures the compliance of the program by keeping track of the medication requests. Additional Duties and Responsibilities Attend staff meetings. Performs other duties as assigned. Patient Centered Medical Home Essential Responsibilities (Principals) Collaborate with individual patients, their personal physicians, and when appropriate the patient’s family to ensure accessible, comprehensive, compassionate, and culturally competent care. Facilitate care by registries, information technology, health information exchange and other means to assure that patients get the indicated care when and where they need and want it in a culturally and linguistically appropriate manner. Ensure all decisions respect patients’ wants, needs, and preferences and that patients have the education and support they require to make decisions and participate in their own care. Continually strive to attend to each patient “whole person,” in the context of the patient’s personal and medical history and life circumstances, rather than focusing on a particular disease, organ, or system. Job Requirements Education: Medical Assistant Certificate, Registered Dental Assistant, and/or Bachelor’s Degree preferred. Certification Required: Current valid CPR certificate Experience: 3 years of experience in a related field preferred. Verbal and Written Skills to perform the job: Bilingual preferred. Familiarity with basic word processing, spreadsheet, and database applications. Accurate keyboarding skills. Technical knowledge and skills required to perform the job: Excellent verbal, written and interpersonal communication skills and the demonstrated ability to work with diverse individuals and groups. Demonstrate high levels of self-initiation and direction. Knowledge of communities we serve. Knowledge and experience working in medical settings and interacting collaboratively with medical teams. Skill in analyzing situations and making timely decisions. Physical and Mental Requirements Work involves sitting, talking, hearing, using hands to handle, feel or operate objects, tools, or controls, and reaching with hands and arms. The employee may be required to push, pull, lift, and/or carry up to 20 pounds. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Quality Management Display knowledge of normal signs of human development and ability to assess and provide age appropriate care. Contribute to the success of the organization by participating in quality improvement activities. Customer Relations Respond promptly and with caring actions to patients and employees. Acknowledge psychosocial, spiritual and cultural beliefs and honor these beliefs. Maintain professional working relationships with all levels of staff, clients and the public. Is part of a team and cooperate in accomplishing department goals and objectives. Interacts and communicates in a manner to reflect an understanding of the patient’s age, culture, state of health, and level of comprehension. Safety Maintain current knowledge of policies and procedures as they relate to safe work practices. Follow all safety procedures and report unsafe conditions. Use appropriate body mechanics to ensure an injury free environment. Is familiar with location of nearest fire extinguishers and emergency exits. Follow all infection control practices including blood-borne pathogen protocols. HIPAA/Compliance Maintain privacy of all patients, employees and volunteer’s information and access such information only on a need to know basis for business purposes. Comply with all regulations regarding corporate integrity and security obligations. Report unethical, fraudulent or unlawful behavior or activity. Work Environment The noise level in the work environment is usually moderate. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. OSHA Compliance Comply with all regulations and required schedules regarding OSHA training. Employee Physical Compliance Required physical to be performed annually. Policies and Procedures Compliance Responsible for following all La Maestra Family Clinic policies and procedures. Meal Period Compliance (Non-exempt employees only.) Punch out before 5 hours from the start of shift for meal periods. Sexual Harassment Training (Management employees only.) Comply with all regulations and required schedules regarding sexual harassment training. #J-18808-Ljbffr La Maestra Community Health Center