Quality Assurance Specialist (TPA)

Job Summary :

The Quality Assurance (QA) Specialist for Third Party Administrator (TPA)-Care First, Community Investment (CFCI) in partnership with L.

A. County’s Justice Care and Opportunity Department (JCOD) is responsible for the compliance of this project, developing and supporting a network of community-based organizations and non-profits as subrecipient Service Providers for Care First, Community Investment Funds.

This position audits service delivery fidelity to awarded subcontracts, service delivery and quality, licensure, certification, physical facility conditions, staff qualifications, and staff-to-client ratios as specified in individual subcontracts.

This position collaborates with the Project Director, Director of Operations and Grant Advocates to establish contracts with CBPs and optimize the utilization of CFCI and non-CFCI funds and comply with funding requirements.

Essential Duties :

Responsibilities include, but are not limited to :

• Monitor subcontracted Service Providers and activities to ensure compliance with administrative and fiscal regulations in accordance with contract provisions.
• Work with network of CBPs to establish ongoing quality assurance monitoring processes and reviews.
• Review Program monitoring tool (Site Visit tool) of subcontracted Service Providers, and supervision implementation of corrective action plans to ensure high quality services are provided under CFCI and non-CFCI funding.
• Provide report updates to leadership team on matters relating to contract compliance.
• Maintain, and update policies and procedures for the general operation of the compliance program.
• Respond to alleged violations of rules, regulations, policies, and standards of conduct by initiating investigative procedures.
• Reports on a regular basis, and as directed or requested to keep the TPA Project Manager and Director of Operations informed on the operation and progress of compliance efforts.
• Additional duties as assigned. Education and Experience :

Required :

• Four (4) year degree in Social Sciences or related fields AND two (2) years of full-time administrative or quality experience working in a substance abuse program with criminal justice offenders OR
• Experience may be substituted for education on a year for year basis, or possess Five (5) cumulative years of full-time administrative and quality control experience with a criminal justice population.

Certifications or Licenses :

• Required : NONE.
• Driver’s License Skills / Abilities :
• Excellent interpersonal and communications skills and the ability to work effectively with a wide range of constituencies in the community and within the organization.

Title : TPA Quality Assurance Specialist Reports To : TPA Project Director Job Number : Department : TPA Position Number : Location : FLSA Exemption Status : Non-Exempt Supervises : N / A Position Status : Full Time Revised : 08-19-24

• Knowledge of contract requirements, objectives, milestones, and other deliverables.
• Knowledge of contracting process and associated local, state, federal and other regulations.
• Ability to multi-task, identify problems, provide recommendations to management team, and implement any applicable systems.
• Ability to work constructively with diverse people and with parties that may have divergent perspectives and interests.
• Ability to clearly express concepts and direction, both orally and in writing, and to prepare complex reports, policies, and procedures.
• Understand and appropriately apply Amity policies and procedures and adhere to agency-wide practices and regulations.
• Strong oral and written communication skills.
• Proficient with software such as Microsoft Office Suite (Word, Excel. Email, Internet, etc.).
• Strong organization and time management skills PROFESSIONAL and ETHICAL RESPONSIBILITIES
• Ensure that excellence and integrity are applied to professional responsibilities in order to ensure optimal services are provided under TPA project;
• Understand and appropriately apply Amity policies and procedures, and adhere to agency-wide practices and regulations; and
• Model professionalism, effective work habits and responsible living. TRAINING and CONTINUING EDUCATION
• Within 90 days of hire, personnel file shall document evidence of participation in the following trainings (as relevant to TPA contract) :

Employee Orientation

CPR Certification, First Aid Certification and an annual Tuberculosis (TB) test

Sexual Harassment Prevention

Emergency Procedures

Confidentiality (Title 42 Code of Federal Regulations (CFR) Part 2)

Health Insurance Portability Accountability Act (Title 45 CFR Part 164)

Signed acknowledgement of Drug Free Workplace policy

• Participate in in-service training regarding the background and purpose of the TPA Project and all relevant policies and procedures.
• Participate in other training as assigned

ADA Information : Physical Requirements :

• Faculty must frequently lift and / or move up to 50 pounds.
• Frequently required to sit and / or stand for extended periods of time.
• Frequently required to type for extended periods of time.
• Occasionally required to reach, walk, climb, pull, push, grasp, stretch, stoop.
• Frequently required to talk, hear, see, and use repetitive motions.
• Frequently able to communicate in verbal and written form.
• Frequently able to use all types of vision, such as close vision, distance vision, color vision, peripheral vision, and depth perception, to complete daily tasks.
• Required to wear comfortable and office appropriate clothes. Mental Demands :
• Ability to change direction as priorities shift.
• Ability to thrive in an environment that requires one to adapt to changing circumstances.
• Ability to professionally work under pressure with difficult or temperamental students, faculty & Service providers.
• Ability to handle mental and emotional stress related to the position. Work Conditions :
• Generally, in an indoor office setting. Environmental Conditions :
• The noise level in the work environment is moderate but can be loud.
• The temperature in the work environment is usually moderate to cool but can be cold or hot. Travel :
• Required travel locally by owned vehicle.
• Valid insurance required
30+ days ago