Quality Assurance and Improvement Specialist

Overview

Prestige Healthcare Resources Inc (PHRI) is seeking an experienced, pro-active, thoughtful team member who can make a substantial and valuable impact to the organization. We currently provide services to over 1,500 patients in two different states. We are in growth mode and looking to scale to providing care to over 10,000 patients in 5 different states over the next 3 years. Our focus is advocating and implementing an integrated care model approach to the underserved population undergoing behavioral health related issues.

Providing compassion and care isn’t just our profession, it’s our passion…and our culture. At Prestige, we care for the clients that we serve. We listen to them and provide the support they need to enable them to live comfortable and fulfilling lives. Our drive is to restore hope and healing to the community. We are looking for mission-driven individuals looking to make a difference.

Position Summary

The Quality Assurance and Improvement (QA/QI) Specialist guarantees adherence to ethical standards, regulatory and contractual obligations, service delivery standards, practices, protocols, and all QA/QI functions. This role involves conducting comprehensive quality assurance audits, analyzing data from consumer charts, consumer care, and service provision aligned with Federal, State, and local government regulations, alongside internal operational protocols. Additionally, the QA/QI Specialist oversees incident reports, event reports, grievances, consumer satisfaction surveys, and delivers analysis reports and recommendations to the Director of QA/QI and COO. 

Primary duties & responsibilities

• Review and analyze all incident, event reports, grievances, and consumer satisfaction surveys, as well as internal audit reports findings, trends, and recommendations to the Director of QA/QI.

• Establish and maintain collaborative relationships with all levels of the internal service delivery system.

• Maintain confidentiality of records related to consumer care across all Departments, Divisions, and Programs.

• Conduct thorough quality assurance audits and analyze data related to consumer charts, consumer care, consumer service provision, and consumer satisfaction in accordance with Federal, State, and local government policies, procedures, certifications, internal standard operating procedures, and expectations.

• Partner with department directors and managers to facilitate incident reporting requirements, including submission, tracking, and trending of critical incidents.

• Conduct thorough investigations into consumer complaints, grievances, and incidents; then report and document the data following Federal, State, and local government policies, procedures, certifications, internal standard operating procedures, and expectations.

• Assist in developing internal improvement plans/corrective actions to enhance quality compliance and positive outcomes.

• Assist in documenting processes, procedures, and workflows related to all work carried out by the QA/QI Department.

• Adhere to PHRI policies and procedures to ensure quality care.

• Please note that the statements above describe the general nature and scope of the work performed in this position and do not encompass all responsibilities, duties, and skills required. Other duties may be assigned as necessary.

Experience and Professional Qualifications

• To excel in this role, one must proficiently perform all essential duties. The qualifications below reflect the necessary knowledge, skills, and abilities. Reasonable accommodations can be provided for individuals with disabilities to carry out essential functions. 

• Excellent verbal and written communication skills.

• Proficient in Microsoft Outlook, Word, Excel, and other standard software applications.

• A Bachelor’s Degree may be substituted for five additional years of Quality Assurance experience and professional qualifications.

• 3-5 years of work experience in Human Services or a related field.

• 3-5 years of work experience in qualitative and quantitative analysis or similar areas.