PEM-Quality Management Analyst (Care Management)

Job Description

Job Description

Overview

he Quality Management Analyst (QMA) will lead the quality improvement process through the analysis and support of creating and implementing corrective actions and improvement plans for the Children’s Care Management Program. The QMA will assist in creating systems to help in collecting, coding, verifying, and monitoring data. The role of the QMA is to ensure that programs are meeting compliance standards, performance quality is maintained, and that specified goals and outcomes are met.

The Quality Management Analyst for Care Management serves as a liaison to: Collaborative for Children and Families (CCF), New York State Office of Children and Families Services (OCFS), Department of Health (DOH) and New York State Medicaid Program.

Key Responsibilities

• Perform monthly case record reviews and internal billing audits.
• Make recommendations whether programs need to be on an internal performance improvement plan (PIP).
• Develop and update instruments used to measure programmatic goals and outcomes.
• Ensure timely submission of Corrective Action Plans, internally and to external monitoring agencies.
• Process and input data as needed through various internal and external data collection and reporting systems.
• Assist departments in reporting and determination of outcomes through the monthly Quality Management Compliance Meetings.
• Assist and guide programs with creating protocols and procedures.
• Collaboration with external monitoring and accreditation agencies
• Other administrative duties as assigned.

Qualifications

• BA/BS required in Social Work or related human services
• Must have ability to analyze and manipulate data.
• Must have working knowledge of computer applications, preferably highly skilled with Microsoft Office.
• Knowledge of Foothold and MAPP systems.
• Must have commitment to enhancing the level of service delivery provided to persons served.
• Must be able to write reports from database information.
• Excellent organizational & interpersonal skills.
• Good verbal /written communication skills.

Supervisory Responsibility

No

Work Environment: Office

Position Type/Expected Hours of Work: Full Time/35

Travel (if required): O ther Rising Ground location if needed

Benefits & Compensation

• Competitive salary structure
• Health, dental, and vision insurance
• 401(k) with company match
• PTO policy (11 Paid Holidays, Paid Sick Time, Paid Vacation & Paid Personal Days)
• Remote / flexible work options (If applicable)