The Quality Assurance Manager supports the company to ensure the completeness, adequacy, and appropriateness of care, quality of care, and efficiency of utilization of provider resources, and to ensure compliance with appropriate laws, rules, regulations, and standards. The QA Manager will work jointly with and cooperate with OCR and DHS for the implementation and enforcement of HIPAA; will work jointly with and in cooperation with Administration and Staff; and will work jointly with and in cooperation with general legal counsel.
The QA Manager will serve as the company’s primary point of contact for the national accreditation organization and will coordinate/communicate with the organization regarding surveys and any necessary corrective actions. The Manager will serve as Medical Records Librarian and will be responsible for ongoing quality controls and for continuity of client care; assuring that client records are maintained, completed, and preserved; that required indexes and registries are maintained and that statistical reports are prepared; will ensure that information regarding enrolled clients is immediately retrievable, establishing a central records index, and maintaining service records in such a manner as to enable a constant monitoring of continuity of care.
- Supervises and leads the Quality Assurance and Medical Records Departments in order to satisfy the essential job functions as outlined below.
- Represents the QA Department to the Administrative Team as needed and/or requested.
- Oversees audits of medical records charts.
- Assists in monitoring the company’s compliance with HIPAA, Corporate Compliance, Medicaid, The Joint Commission, and other Federal/State regulatory agencies.
- Represents the company and assists with audits by external agencies.
- Provides education and support for direct care staff/contractors regarding documentation.
- Provides support for Clinical Liaisons.
- Assists with the development and implementation of quality assurance forms/programs.
- Assists with the collection of data and analysis of data, regarding processes to ensure quality and efficiency of services.
- Collaborates with the Admin Team and Consultants to develop and implement EHR Documentation Releases.
- Collaborates with the appropriate authorities and internal Information Technology staff regarding the annual Security Risk Analysis and necessary corrective actions.
- Implements all requirements under the Security Regulations of HIPAA within the covered entity. This includes the following:
- Implementation, creation, and supervision of the HIPAA Compliance Team
- All administrative safeguards, policies, and procedures.
- Implementation of all security physical safeguards, policies and procedures.
- Implementation of all technical security safeguards, policies and procedures.
- Implementation of all security organizational safeguards, policies and procedures.
- Implementation of all electronic transactions and code sets standards.
- Implementation of national provider identifier (NPI) standards.
- Implementation of privacy standards.
- Implementation of all other federal and state security standards required by statute.
- Implements risk management and risk analysis always striving to improve security and privacy beyond the statutory requirements of HIPAA.
- Implementation of all requirements under the Privacy Regulations of HIPAA within the covered entity. This includes the following:
- Implementation of privacy notice.
- Implementation of inspecting copy program.
- Implementation of amendment and correction program.
- Implementation of accounting and disclosure program.
- Implementation of restrictions and alternative communication programs.
- Implementation of consents and authorization for release of health information to all sources.
- Implementation of the minimum necessary rule.
- Implementation of the privacy training program.
- Implementation of the sanction program.
- Implementation of all the safeguards to protect health information.
- Implementation of the security regulations as they apply to medical records.
- Implementation of all other federal and state laws pertaining to the privacy of medical records.
- Other projects as assigned.
EDUCATION
Master’s degree required. Licensed mental health professional in the State of Arkansas. Experience in medical records and a mental health setting required.
JOB SKILLS
Required: Knowledge of regulating entity’s (Medicaid/PASSEs/The Joint Commission) requirements, HIPAA privacy and security regulations, Corporate Compliance, and medical records regulations.
Preferred: Supervisory experience, proficient computer skills, excellent spelling and grammar skills, strong organizational and communication skills. Professional work ethic. Ability to deal effectively with the public and staff.