Quality Compliance, Incident Specialist (QCIS)

Under the supervision of the Vice President of Quality & Compliance and the Director of Quality Improvement, coordinates the creation and review of all billing related Life Plan/Staff Action Plan documentation and provides ongoing support, training, and internal auditing to all assigned programs. Ensures that all program documents are created and received in accordance with regulatory timeframes

Role Responsibilities:

• Responsible for training assigned programs new Quality and Compliance initiatives and projects.
• Provide management with support and training on new documentation requirements as well as Medisked and Life Plan/Staff Action Plans training for new AM or AD staff.
• Acts as an additional liaison to the Care Coordination Agency and PHP staff.
• Coordinates and attends regular meetings with CCOs to support management and address issues as needed.
• Maintains and makes necessary changes to management procedures and training materials as needed based on OPWDD ADMs and evaluations of staff efficiency.
• Works with Electronic Health Record Data Manager as super-user for Medisked system on improvements and issue resolution.
• Facilitates meetings with onsite teams to provide input and advice and communicates outcomes with Program Managers/Assistant Directors.
• Audits and approves Staff Action Plans, in the absence of an AD/PM when assigned, on Medisked and ensures Staff Action Plans match up to Life Plans.
• Periodically reviews Program files for accuracy and organization on site and completes desk audits of samples of monthly required documentation and Staff Action Plans.
• Assists with Agency investigations. Will obtain investigation training and support the Quality Department with conducting investigations, as needed.
• Assists with onsite quality and compliance reviews.
  

• Three years of experience with Program Planning documentation preferred.
• Proficiency in Microsoft products, electronic data systems and web-based systems
• High School Diploma or GED
• New York State Drivers License
• Must be able to display a high level of discretion and understand the sensitive nature of confidential employee information with superior emotional intelligence.

• Health Care Plan (Medical, Dental & Vision)
• Retirement Plan (401k, IRA)
• Life Insurance (Basic, Voluntary & AD&D)
• Paid Time Off (Vacation, Sick & Public Holidays)
• Short Term & Long Term Disability
• Training & Development