质量审查专员III级
Quality Review Specialist III
Qlarant 是一家非营利性公司，与公共和私营部门合作，创建高质量、安全且高效的医疗保健和人类服务项目。我们有多个业务线，包括人口健康、使用审查、管理护理组织质量审查以及为发育障碍人士提供服务的项目的质量保证。Qlarant 也是全国范围内打击大型组织欺诈、浪费和滥用行为的领先者。此外，我们的基金会为服务于弱势群体的项目提供资助机会。
最佳人才，最佳方案，最佳成果
职位概述：
协助进行常规评估，以确定智力发育障碍（IDD）人士是否获得根据其独特需求和具体情况量身定制的支持和服务。执行定期审查，以评估 IDD 服务提供者在保护其照护对象的健康和安全方面的有效性。协助管理层识别服务交付中的改进领域，提供技术支持，生成有意义的建议，并与服务提供者合作实施持续改进，以满足发育障碍人士的需求。
主要职责：
- 对项目和服务提供者进行详细评估，以评估其有效性和对既定标准的遵守情况。
- 确保项目符合与发育障碍相关的法律法规和政策。
- 确定项目和服务中的改进领域，并与相关方合作实施质量提升计划。
- 检查服务提供者的文件、报告和记录，以确保以尊重和审慎的方式满足其需求。
- 为发育障碍人士的权利和福祉发声，确保以尊重和以个人为中心的方式满足其需求。
- 分析与项目成果、客户满意度和其他相关指标相关的数据，以支持决策和持续改进工作。
- 与为发育障碍人士提供服务的服务提供者、机构和相关方进行沟通。
- 为员工和服务提供者提供技术支持、培训和指导，介绍最佳实践和质量标准
查看英文原文
Qlarant is a not-for-profit corporation that partners with public and private sectors to create high quality, safe, and efficient delivery of health care and human services programs. We have multiple lines of business including population health, utilization review, managed care organization quality review, and quality assurance for programs serving individuals with developmental disabilities. Qlarant is also a national leader in fighting fraud, waste and abuse for large organizations across the country. In addition, our Foundation provides grant opportunities to those with programs for underserved communities.
Best People, Best Solutions, Best Results
Job Summary:
Facilitates routine evaluations to assess the extent to which individuals with intellectual developmental disabilities (IDD) are receiving customized support and services tailored to their unique needs and specific situations. Performs scheduled reviews to assess how effectively IDD service providers are in preserving the health and safety of the individuals in their care. Assists management in identifying areas for improvement in service delivery, providing technical assistance, generating meaningful recommendations, and collaborating with service providers to execute continuous improvements that meet the needs of individuals with developmental disabilities.
Essential Functions:
- Administers detailed evaluations of programs and service providers to assess their effectiveness and adherence to established standards.
- Ensures that programs comply with relevant laws, regulations, and policies related to developmental disabilities.
- Determines areas for improvement in programs and services and works with stakeholders to implement quality enhancement initiatives.
- Inspects documentation, reports, and records to providers to ensure that their needs are met in a respectful and prudent manner.
- Advocates for the rights and well-being of individuals with developmental disabilities and ensures that their needs are met in a respectful and person-centered manner.
- Analyzes data related to program outcomes, client satisfaction, and other relevant metrics to inform decision-making and continuous improvement efforts.
- Communicates with service providers, agencies, and stakeholders involved in providing services to individuals with developmental disabilities.
- Develops and provides technical assistance, training and guidance to staff and service providers on best practices, quality standards, and compliance requirements.
- Exercises professional judgment and takes immediate action in the case of abuse, neglect, and/or exploitation by following established protocols.
- Conducts interviews with individuals receiving services and provider staff in a respectful manner.
- Documents accurate review findings and generates reports based on the results.
Level of Supervision Received:
Plans and arranges own work; works with manager to prioritize projects
Education (can be substituted for experience):
Minimum Bachelor's Degree required
Work Experience (can be substituted for education):
5 - 7 years of experience required; 8 - 11 years preferred
Certification(s):
Must meet the criteria to be a Developmental Disabilities Professional (DDP) and Qualified Intellectual Disabilities Professional (QIDP)
Qlarant is an Equal Opportunity Employer of Minorities, Females, Protected Veterans, and Individuals with Disabilities.
Qlarant is a drug-free workplace. All offers of employment are contingent upon successful completion of pre-employment background and drug screens.
Originally posted on Himalayas