Visiting Nurse Service of New York Looking for Quality Assurance Specialist at Manhattan, NY Full Time

Monitors staff assignments, including but not limited to, outgoing calls, effective and appropriate escalation resolution, and auditing of record documentation to ensure compliance. Collaborates with the management team in developing and sustaining quality programs and initiatives to address the needs of the staff. Works under general direction.

Responsibilities

• Facilitates effective department operations by maintaining a strong working relationship and fostering communication among all staff and management.
• Develops, creates and distributes analytical reporting associated with employee score cards and/or the Call Handling Scores of staff.
• Meets regularly with the management team to ensure that the quality program is running effectively and addresses any gaps that may exist.
• Collaborates with other departments to develop quality programs, workflows and guidelines specific to program operations.
• Investigates and assists with regulatory inquiries. Reviews, analyzes and problem solves routine and complex situations.
• Assists with Quality Assurance and system testing, as assigned.
• Assists management team in providing orientation/education to new hires, as assigned.
• Participates in special projects and performs other duties, as assigned.

For Authorization Team only:

• Monitors and evaluates authorization data to ensure accuracy and compliance regulations are met. Assists management in developing performance improvement programs for staff.
• Audit’s authorization records, provides feedback, and assists with corrections when discrepancies are identified.

For MLTC Care Coordination:

• Monitors and evaluates outgoing staff calls to ensure that they are disseminating accurate information with optimal concierge level customer service in adherence to our Call Handling Standards.
• Monitors staff outgoing calls to ensure they are meeting the quality standards of concierge level of record documentation.
• Uses data obtained from monitoring calls to provide coaching, feedback and assistance to staff to aide in their development.
• Assists staff in developing performance improvement programs for staff.

Qualifications

Education: Associate’s degree or equivalent work experience required.

Experience: Minimum two years of health care experience required, preferably focused around quality assurance. Experience in a healthcare related organization preferred. Excellent written and verbal communication skills and ability to motivate others required.