Quality Management Specialist

Indera is looking for a Quality Management Specialist, NHTD/TBI

Job Responsibilities:

Incident Reporting:

• Assist with Serious Reportable Incident process, assuring compliance and the timely completion and submission of all required documentation associated with investigatory process both internally with the RRDC and with the waiver providers across an 8-county region
• Track all pertinent information pertaining to SRIs for analysis to identify any regional trends and emerging issues

Quality Monitoring:

• Perform internal DOH RRDC file reviews of a sample of participant records quarterly and confirm adherence to proper authorization procedures and satisfaction of waiver requirements
• Perform waiver provider service audits across an 8-county region with 40 plus providers
• Perform trend analysis identifying problematic areas across an 8-county region, and develop activities/trainings that will support positive outcomes
• Develop, implement, and ensure completion of plan(s) of corrective actions
• Ensure waiver participants complete annual participant satisfaction surveys using the DOH designated form to assess participant satisfaction with NHTD/TBI waivers and to monitor quality assurance activities

Review of Services Plans and Provider Applications:

• Assist RRDS in reviewing Service Plans upon request to ensure information is accurate and meets the health and welfare needs of the participant
• Assist with provider enrollment process and submission to DOH

Develop and Submit Reports to DOH:

• Review quarterly and annual SRI reports from the waiver providers
• Submit a monthly numbers report for the NHTD/TBI to DOH waiver staff
• Submit quarterly SRI reports for NHTD/TBI to DOH waiver staff
• Submit quarterly complaint reports for NHTD/TBI to DOH waiver staff
• Make recommendations to the Lead RRDS/DOH based on experience for improvements to NHTD/TBI waiver policies and procedures

Professionalism:

• Uphold the codes of conduct and ethics as well as all Indera policies and procedures
• Exercise sound judgment as a matter of course and hold protected health information and other sensitive information in the strictest of confidence in accordance with ARISE and HIPAA policies
• Other duties as assigned

Confidentiality: High-level confidentiality is required for access to all organization records.

Safety Compliance: Office functions are performed while maintaining a safe work environment.