The Intellectual/Developmental Disability
(I/DD) Quality Assurance Coordinator is responsible for developing and consistent implementation of systems that monitor the quality and integrity of I/DD Care Coordination, ensuring timely identification and remediation of any concerns. This employee also assist with operational leadership and ensures a system of ongoing training and professional development for all I/DD Care Coordination team members. This role requires extensive clinical and management skills due to the complex needs of the individuals supported and the importance of consistency across Community Operations Centers.
The I/DD Quality Assurance Coordinator is responsible for (though not limited to):
Closely monitors performance and risk management across the system through methods such as observation and data review, ensuring timely remediation of any identified issues
Assists in oversight and tracking implementation of new waiver slots to ensure waiver compliance and timely implementation of services
Assists in oversight and tracking implementation of waiver transfers to ensure waiver compliance and smooth transition
Monitors Medicaid deductible coordination efforts monthly and ensures timely identification and remediation of any issues
Monitors Medicaid eligibility issues as identified by finance department, researches and intervenes to resolve issue, collaborates with local Care Coordination staff to request face-to-face intervention when necessary
Ensures that data on critical performance measures is collected, analyzed and available for review by Regional Specialty Team
Oversees collection of QI Data from each Community Operations Center (e.g., service deviations, Case Record Review, etc.) and completes quarterly analysis/summary of performance data
Monitors trends in service utilization and implementation through review of documentation and data
Completes required QI Reporting for I/DD Care Coordination
Monitors and assesses training needs of I/DD Care Coordination team members on an ongoing basis
Assists in development of training materials (e.g., checklists, Power Points, reference documents, etc.) and maintenance of comprehensive I/DD Care Coordination Operations Manual
Provides individual and/or group training on topics related to I/DD Care Coordination
Ensures program of ongoing professional growth/development for team members (e.g., facilitates lunch-n-learns or other training opportunities quarterly)
Utilizes and models person centered planning methods/strategies during mentoring/training and actively encourages use of person centered planning tools in provision of Care Coordination and in management
Collaborates closely with Regional I/DD Care Coordination Manager to ensure development, distribution and training of needed operational protocols, checklists and tools to ensure effective and consistent delivery of I/DD Care Coordination across Community Operations Centers
Desired Skills & Abilities
Knowledge and experience working in field of Intellectual/Developmental Disabilities, with working Knowledge in the areas of dual diagnosis
Knowledge of how adults learn
Ability to mentor and empower others to ensure high quality services
Ability to develop effective operational protocols, tools and resources
Knowledge of and ability to effectively facilitate quality enhancement efforts
Ability to provide effective and clinically sound education/training to others
Ability to use good judgment and make data-based decisions
Ability to establish and maintain positive and effective working relationships with others both within the company and community.
Ability to express directions, comments and opinions clearly and concisely in oral and/or written form.
Ability to understand and interpret complicated written material and verbal presentations.
Skill and ability to demonstrate diplomacy as well as the ability to handle stressful situations
Ability to demonstrate initiative and effective problem-solving skills
Ability to lead by example
Functional computer skills (Word, Excel, Microsoft Outlook, Internet)
Ability to assess personal strengths/needs and identify needed training to promote own professional development
Ability to exemplify a positive, solution-focused attitude and to promote same in others
A bachelor’s degree in human services field and 5 years of professional experience with the population, preferably in a managed care waiver environment
Must qualify as a QP for Intellectual/Developmental Disabilities.
Minimum of 2 years management/administrative or quality assurance experience required. Master’s Degree preferred
The employee will work in an office, with travel throughout state. This may require additional hours beyond standard workday. Business deadlines and crisis issues may require the employee to work over 40 hours per week or on the weekend. Employee must be able to alter daily operations to fit the demands of the position
Cardinal Innovations is North Carolina’s largest Managed Care Organization providing Medicaid managed care and state-funded behavioral health plans. Our mission is to enhance the health and well-being of individuals and their families by creating and managing quality healthcare solutions for those who depend on the public system for care. Our plans reflect the uniqueness of our local communities and are capable of making continual adjustments and improvements to meet the changing needs and priorities of our clients. Cardinal Innovations values the contribution of all stakeholders, and our businesses are based on the principles of respect, collaboration, and mutual accountability.
Cardinal Innovations is an Equal Opportunity Employer. Visit our website at www.cardinalinnovations.org to view all vacant positions and apply on line.