Quality Assurance Program Manager

Job Description

Job Description

The Program Manager of Quality Assurance is responsible for overseeing and ensuring the delivery of high-quality services and supports to individuals in all DDA funded programs.

This position will ensure department is maintaining compliance with regulatory standards as it relates to policies and procedures for reportable incidents;

Person-Centered Planning, and supervision of Case Management Team, internal and external systems. The positions assures compliance with CARF, COMAR, State and Federal regulations, while supporting department teams in active participation in continuous quality improvement activities.

• Write and submit incident reports for all departments to external agencies within 48hours of incident occurring.
• Completes all follow-up investigation reports within the appropriate time frame for all internal / external incidents per DDA Polices on Reportable Incidents
• Collect and submit monthly QA internal documentation
• Identify and coordinate behavioral services in conjunction with Case Manager and Person-Centered Plan, as needed
• Ensure behavioral data is entered in EMR and collected per behavioral plan requirements
• Assesses clients' social, emotional, financial, health, vocational, or other problems to develop rehabilitation treatment plan, or Individualized Plan goal for Person-Centered Plan
• Provide incident and behavioral documentation to Case Manager and PCP Team during annual meetings and / or upon request
• Oversite and coordination of Standing Committee
• Oversight of Person-Centered Plan and ensure implementation of the internal PCP process to avoid service authorization gaps
• Review iCM PCP Compliance Report weekly and follow-up on any PCP's that are out of compliance or off track
• Monitor service utilization and work collaboratively with stakeholders to resolve issues with under or over utilization
• Ensure that individuals supported, families and CCS's fully understand services provided by Company so that PCP reflects all needed services to maximize funding.
• Audit iCM on an ongoing (frequent) basis to ensure that, service notes, staff trainings and billing justification documentation is in place for services provided,
• Work closely with all departments in a positive manner to move PCPs forward in the process
• Maintain a good working relationship with external stakeholders, such as families, other community providers, DDA and CCS agencies to establish funding, goals and troubleshoot any issue with PCP's and / or LTSS.
• Conducts and manages LTSS / iCM documentation and systems training as needed or based on departmental needs and staff requirements
• Assists in annual QA Plan submissions
• Lead on responding to all Plans of Corrections for any deficiencies found during an audit or stakeholder investigation
• Prepares and maintains written case records, reports, performs case follow-up and closing, and performs other administrative tasks as required
• Coordinate and implement general departmental projects
• Back-up for absent employees, and shift rotations based on departmental and individual’s needs
• On call for staffing and clinical emergencies
• Respond to and resolve customer complaints
• Attend all mandatory meetings
• Oversees the Electronic Medical Record
• Is on-call for all departmental needs
• Participates in and successfully completes all required trainings
• Adheres to all County, State DDA, MHA, and MBON policies and procedures
• Other duties as assigned

SUPERVISORY RESPONSIBILITIES

• Manages assigned departmental employees.
• Is responsible for the overall direction, coordination, and evaluation of services.
• Carries out supervisory responsibilities in accordance with the organization's policies, accreditation requirements and applicable laws.
• Responsibilities include interviewing, hiring, terminating and training employees; planning, assigning, and directing work;

appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems .

QUALIFICATIONS

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and / or ability required.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Must be able to work individually as well as within a team.
• Must be able to multi-task.
• Must be able to work with high-risk consumers who have mental illnesses as well as developmental and physical disabilities (ie : must have patience, and must be able to communicate with diverse consumers, etc. effectively).
• Must be able to effectively, and professionally communicate with other staff and individuals served.
• Must possess excellent written and oral communication skills. Must be familiar with COMAR regulations and have a commitment to the public interest.
• Must be able to be trained on Electronic Medical Record Software and State billing systems.

EDUCATION AND / OR EXPERIENCE

Bachelor’s Degree in a human service or related field of study; OR associate degree and (1) year of experience providing to adults with ID / DD and SPMI and (2) years of case management and / or coordination of care;

OR equivalent combination of education and experience.

CERTIFICATES, LICENSES, REGISTRATIONS

Must be able to pass DDA core training successfully

DRIVING / TRAVEL

While performing the duties of this job, the employee must have access to a vehicle to use for business purposes. The employee must possess a valid Driver’s License (with no more than two points) and proof of current automobile insurance.

WORK ENVIRONMENT

While performing the duties of this job, the employee is regularly exposed to outside weather conditions. The noise level in the work environment is usually loud.

The employee may be required to ride in a vehicle for extended periods and walk wherever necessary to perform essential duties and responsibilities.

Reasonable accommodation may be made to enable individuals with disabilities to perform the essential function.

About Us :

At Rock Creek Foundation, a subsidiary of The Sante Group, we believe that having a disability and / or a mental illness should not prevent anyone from having the opportunity to participate in everyday life.

That’s why we have been pioneering the field of behavioral health services for the dual-diagnosed : people living with developmental disabilities as well as severe and persistent mental illness.

We want to ensure that each person we serve can develop the skills they need to live as independently as possible, in their own communities and is able to realize his or her potential in ways that they could not do so before.

The Sante Group aspires to create an organization that places value on collaboration, innovation, creativity, and inclusivity.

To achieve this success, it is essential that all members of our organization feel secure, welcomed, and respected. All members of our organization have a responsibility to uphold these values.

The Sante Group is an Equal Opportunity / Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, age, protected veteran status, or disability status.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this job.

The Sante Group participates in E Verify. http : / / www1.eeoc.gov / employers / upload / eeoc self print poster.pdf