QUALITY ASSURANCE & CONTRACTS SPECIALIST -HYBRID

Job Description

Job Description

The candidate must reside within the following county(s) within Region 8: Bexar, Kerr, Bandera, Gillespie, Kendall, Comal, Guadalupe, Frio, La Salle, Atascosa, Wilson, Karnes, Victoria, Gonzales, De Witt, Lavaca, Calhoun, Jackson, Goliad, Val Verde, Edwards, Real, Kinney, Uvalde, Medina, Maverick, Zavala and Dimmit County.

PRIMARY FUNCTION/RESPONSIBILTY

 

The Quality Assurance and Contract Specialist is responsible for ensuring compliance with all processes, regulations and minimum standards as outlined in the Provider contract. The Quality Assurance and Contract Specialist will collaborate with the network of providers under contract with Belong to review, monitor, and report performance on all aspects of substitute care. Additionally, the Quality Assurance Specialist works with the provider network to develop and implement performance improvement plans and tracks results to ensure all issues are remediated. 

ESSENTIAL DUTIES AND RESPONSIBILITIES  

• In collaboration with the Vice President and Supervisor of Quality Assurance and Contracts develop qualitative indicators, outcomes and outputs that can be used by the Department to objectively measure the Provider’s performance and leverage those measures to improve services.
• Reviews the results of quality assurance reviews and other outputs such as critical incident reports and grievances and appeals, to recommend and initiate system/process improvements.
• Measure’s performance outcomes established at the federal and state level in relation to Belong and its provider network.
• Ensures Provider implements a defined process to complete and review background checks and to verify staff education levels and professional licenses.
• Reviews and analyzes cases, notes, deficiencies, and extracts data to be verified; collects performance data; identifies adverse trends; and determines compliance with service delivery standards, program requirements and policies/procedures.
• Works and supports network providers in Quality Improvement efforts to mitigate risks and improve outcomes for children in their care.
• Provides recommendations and executes solutions in Performance Quality Improvement meetings to ensure outcomes are achieved.
• Maintains strong business relationships with provider network staff to facilitate collaboration and cooperation.
• Serves as a liaison to monitor and assure response to all client-reported concerns and complaints relating to services provided by Belong or the Provider Network.
• In collaboration with the Finance Department, reviews financial records to ensure accurate billing.
• Create and produce reports reflecting the performance measures of provider network; identify trends and make recommendations for improvements.
• Collaborate with Training Department to conduct trainings based on areas of expertise that can benefit Network providers, Belong employees, or SJRC Texas employees.
• Adheres to all policies and procedures of the agency and its accrediting and standard setting bodies such as Council on Accreditation and state licensing.
• Maintains client confidentiality per Belong standards and all applicable codes of ethics.
• Learns, understands, and supports the Belong mission, purpose, and function.
• Carries out the Trauma Informed Care principles and practices for both internal and external stakeholders.
• Responsible for the environmental, cultural, safety, diversity issues and needs of the clients and others that enter the work area.
• Attends mandatory trainings as defined in positions training matrix.
• Attends continuing education as necessary to expand knowledge and maintain certifications or licenses.
• Uses outside professional collaboration and intra-agency teamwork appropriate to the agency.
• Skilled in organizing work in an environment with multiple challenges and priorities with minimal supervision.
• Avoid all conflicts of interest, real or perceived.
• Performs other related duties as assigned.

QUALIFICATIONS

Required:

• Bachelor’s Degree from an accredited college or university in Social Services, Accounting, Business Management, or related field. Experience and education years may be combined to meet education requirement.
• 3+ years in Child Welfare, Data Analysis, Quality Assurance & Contracts
• 3+ years’ experience

Preferred:

• Master’s Degree from an accredited college or university in Accounting, Business Management, or related field.

Certifications/Licenses/Registrations:

• Valid Texas Driver’s License, good driving record, ability to provide own transportation and proof of current automobile insurance.

PHYSICAL/MENTAL REQUIREMENTS

Physical Demands

• Body mobility to stoop, kneel, bend, reach, and walk (roll) short distances in order to operate equipment.
• Must be able to lift up to 15 pounds with assistance.

Visual and Cognitive Demands

• Communicate both verbally and in writing.
• Give and receive verbal and written instructions.
• Have fine vision, have sustained vision, and peripheral vision.

Environmental Demands

• Position is assigned to the Quality Management Department.
• Minimum of 40 hours per week but may necessitate additional time in order to complete assigned work.

Work Environment

• Settings with varying moderate to high degrees of background noise.
• Light and ventilation found in typical setting.
• Campuses are smoke-free, except on permitted campuses in designated areas.

Possible Hazards

• Possible injury when lifting or moving if employee fails to use proper body mechanics, or if proper techniques are not used.

DESCRIPTION OF ORGANIZATIONAL RELATIONSHIP/REPORTING RELATIONSHIPS   

Supervised by: Quality Assurance and Contracts Supervisor

Supervises: N/A