Job description
Serves as a Quality Assurance Monitoring Specialist with the Quality Assurance Unit. Quality Reviews include Long Term Care, Home and Community Support Services Agency (HCSSA), Health Care Quality/Acute Care (HCQ), and Substance Abuse/Narcotic Treatment Program complaints and self-reported incidents. Reviews daily intakes of all allegations of abuse, neglect, and exploitation received by intake specialists to determine if it is a violation and to ensure timely and accurate triage and prioritization. Edits reports prepared by intake specialists prior to sending electronically to the regional offices for Investigation and to ensure quality control and accountability standards are maintained. Analyzes and interprets Regulatory Services policies, procedures and regulations. Provides consultation to agency staff, providers, advocates, consumers, legislators and other agencies. Serves as a liaison between the Complaint Intake Unit and regional field operations staff. Assists with the intake of complaints, incidents, and requests for information. Performs related work and may participate in special projects and workgroups as assigned. Interprets policies, procedures, rules, regulations and standards and communicates on a complex level with others to exchange or verify information, respond to inquiries, address issues or resolve problems. Performs other duties as assigned.
Attends work on a regular and predictable schedule in accordance with agency leave policy and performs other duties as assigned.
Performs reviews to ensure accuracy/compliance with state and federal regulations (35%)
Evaluates complaints and incidents to ensure appropriate priority assignment (10%)
Interprets policies, procedures, rules, regulations and standards to individuals (10%)
Communicates on a complex level with others to provide, exchange or verify information, answer inquiries, address issues or resolve problems (10%)
Provides instructions, guidance and training to staff (10%)
Refers cases to other program areas or agencies as necessary (10%)
Receives, processes and distributes intakes and incident reports including notifying regional staff of 24 hour priority or 2-day priority (5%)
Serves as liaison for assigned area on complex issues with agency staff and outside entities (5%)
Maintains current knowledge in assigned area by reviewing literature, attending meetings/seminars or communicating with other professionals (5%)
Knowledge of state and federal laws and regulations related to regulatory programs.
Knowledge of health care principles, practices, and procedures.
Ability to effectively communicate, organize and present information,with others orally and in writing to provide information.
Ability to present professional and knowledgeable information to internal and external stakeholders.
Ability to use judgment, make effective decisions and prioritize work.
Ability to analyze and solve problems.
Any one of the following are preferred Registrations, License Requirements or Certifications: Licensed Vocational Nurse (LVN) or Registered Nurse (RN), SMQT, Medical Technologist/Laboratory Technician, Surgical Assistant, Emergency Medical Technician, End Stage Renal Disease/Dialysis Technician, Other License/Degree/Certification in Health Care
Bachelor's degree from an accredited college or university or Nursing Licensure. Related work experience may substitute for the required education on a year for year basis with maximum substitution of four (4) years.
Experience in Regulatory Program, HCSSA Program, or Acute Care Program Preferred. SMQT or RN/LVN Preferred.
Monday-Friday 8:00 am to 5:00 pm. Weekend on-call rotation – one Saturday every 10-11 weeks and occasional evening coverage until 7 pm. Must be available to work holidays as needed. Must be a good fit for the team. This position requires medical knowledge/experience and applicants MUST have a very strong medical/clinical background.
The position is full-time telework with travel to the office as business needs require. Telework employees will not be reimbursed for travel from the employee’s residence to the office. Telework employees are responsible for providing the required infrastructure for working from home.
HHSC does not pay installation, monthly fees, or other charges for additional equipment, personal telephone lines (cellular or land lines), or high-speed internet access in an employee’s residence.
Salary Note: The salary offered will follow HHS starting salary guidelines which are typically made at or near the minimum of the salary range.
No Military Equivalent.
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HHS agencies use E-Verify. You must bring your I-9 documentation with you on your first day of work.
In compliance with the Americans with Disabilities Act (ADA), HHS agencies will provide reasonable accommodation during the hiring and selection process for qualified individuals with a disability. If you need assistance completing the on-line application, contact the HHS Employee Service Center at 1-888-894-4747. If you are contacted for an interview and need accommodation to participate in the interview process, please notify the person scheduling the interview.
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