Quality Specialist

GENERAL DESCRIPTION:

The Quality Specialist monitors processes and analyzes the compliance of internal operational areas with the standards and reference requirements, such as those related to accreditation and Model of Care (MOC), among others. Ensures an adequate revision process, compilation of information, and distribution of documents related to the Model of Care (MOC) and other projects for the company and its line of business. Monitors and analyzes information from reports and policies to evidence compliance and/or to complete projects underway in the Department. Refers tasks and requests to other departments in the company to be properly completed. Regular Exempt

GENERAL DESCRIPTION:

The Quality Specialist monitors processes and analyzes the compliance of internal operational areas with the standards and reference requirements, such as those related to accreditation and Model of Care (MOC), among others. Ensures an adequate revision process, compilation of information, and distribution of documents related to the Model of Care (MOC) and other projects for the company and its line of business. Monitors and analyzes information from reports and policies to evidence compliance and/or to complete projects underway in the Department. Refers tasks and requests to other departments in the company to be properly completed.

ESSENTIAL FUNCTIONS:

Receives, analyzes, and handles requests as required for projects related to the Accreditation Association for Ambulatory Health Care (AAAHC) Accreditation process and the Model of Care (MOC), among others; works closely with internal departments as required by the due process. Contacts, coordinates, and educates departments on the responsibilities of each team and workgroup in preparation for accreditation audits, Model of Care, and department projects. Coordinates and prepares educational material for Quality Department initiatives to be carried out in the department. Maintains electronic files organized and in the required formats to present them in audits. Identifies the information that complies with each requirement related to audits or projects and facilitates the information search for auditors. Keeps track of standards, documentation, binders, and applications in preparation for accreditation audits and models of care. Performs data entry, review of documents, formats, forms, and/or information related to assigned projects as required. Performs coordination of internal and/or external meetings and related tasks to ensure complete execution of projects according to established work plan. Complies with the submission of reports required by regulatory agencies promptly and as requested (ASES, CMS, other internal Company departments). Maintains effective communication with representatives from each department assigned to collaborate with the Quality Department on audits or special projects to ensure compliance with established standards. Submits reports to the Quality Department management staff, as requested, regarding actions taken. Collaborates in the creation and revision process of policies and procedures and participates with the unit's Management Team to define processes. Validates situations from other departments and identifies areas of improvement, depending on the impact of the investigations. Provides administrative support for the quality-of-care processes, when required. Must comply fully and consistently with all company policies and procedures, with local and federal laws as well as with the regulations applicable to our Industry, to maintain appropriate business and employment practices. May carry out other duties and responsibilities as assigned, according to the requirements of education and experience contained in this document.

MINIMUM QUALIFICATIONS:

Education and Experience: Bachelor's degree in Business Administration, Health Services Administration or a related field. At least three (3) years of experience in activity coordination, document auditing, project management, process management, administrative support, and customer/provider service, preferably in a healthcare environment, such as a medical office and/or medical plan. "Proven experience may be replaced by previously established requirements." Certifications / Licenses: N/A Other: N/A Languages: Spanish – Intermediate (comprehensive, writing and verbal) English – Intermediate (comprehensive, writing and verbal) “We are an Equal Employment Opportunity Employer and take Aff… #J-18808-Ljbffr MCS Puerto Rico