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Quality Assurance Specialist/Certified Peer Support Specialist

Job Details

Job Location

Pikeville - 173 Redale - Pikeville, KY

Position Type

Full Time

Education Level

High School

Salary Range

$19.50 - $19.50 Hourly

Description

Position Summary:

Person in this position will be responsible for assisting the agency in ensuring that documentation requirements for Medicaid, Medicare and other funding sources per chapter and contract guidelines are adhered to. Responsibilities include but are not limited to: clinical records review, medical records, staff training compliance, and interdepartmental communication.

Person in this position is also responsible for providing peer leadership, outreach, advocacy, coaching and recovery support within the community. Essential Job Functions include:

Essential Job Functions:

+ Possess and/or develop expertise in the areas of quality documentation and records review in relation to Medicaid/Medicare regulations and all other federal, state and local rules and regulations that apply to WestCare Kentucky’s specific programs.

+ Develop and/or utilize existing monitoring tools, forms, processes and implement systems for compliance in all programs which will ensure that the programs and individuals meet documentation requirements and clinical records through monitoring, education and training

+ Conduct quality assurance site based reviews of client files

+ Coordinate and facilitate ongoing trainings in relation to documentation fundamentals, staff onboarding, and other like trainings as assigned or. based on record review findings

+ Manage and monitor WestCare Kentucky’s annual training plan and conduct staff training outstanding reports and follow up adherence measures.

+ Possess and/or develop expert proficiency in WestCare Kentucky’s electronic health record; in the client file, service manager, and reporting features.

+ Manage medical records; requests, distribution, ROIs, communication, etc.

+ Attend staff meetings, training and in-service as assigned by supervisor and/or as required by the agency;

+ Develop concise and timely reports, including reports by program regarding client file reviews, as necessary and distribute reports to the management team on a defined basis

+ Serve as a positive role-model to individuals and their families, sharing experiential knowledge and skills.

+ Works with individuals, families, and groups to provide outreach and emotional support.

+ Educate and refer clients to community agencies and businesses that appropriately address their need for food, shelter, clothing, employment, transportation, social service benefits, etc.

+ Provides warm hand off to community resources, services, and supports.

+ Provide services that promote wellness, recovery, and resiliency.

+ Assist clients with establishing or re-establishing support systems within their community.

+ Engage with the family members of (or other persons significant to) those in crisis to educate them about self-care and ways to provide support

+ Participate in clinical staffing decisions regarding the patients’ current strengths and resources and their need for additional resources.

+ Engages individuals and families in crisis planning process using evidenced based practices including Motivational Interviewing and Mental Health First Aid.

+ Facilitates stabilization and care coordination services post-acute intervention.

+ Provides after hours services on a rotation schedule.

+ Possess and/or develop expertise in the areas of quality documentation and records review in relation to Medicaid/Medicare regulations and all other federal, state and local rules and regulations that apply to WestCare Kentucky’s specific programs.

+ Develop and/or utilize existing monitoring tools, forms, processes and implement systems for compliance in all programs which will ensure that the programs and individuals meet documentation requirements and clinical records through monitoring, education and training

+ Conduct quality assurance site based reviews of client files

+ Coordinate and facilitate ongoing trainings in relation to documentation fundamentals, staff onboarding, and other like trainings as assigned or. based on record review findings

+ Manage and monitor WestCare Kentucky’s annual training plan and conduct staff training outstanding reports and follow up adherence measures.

+ Possess and/or develop expert proficiency in WestCare ’s electronic health record; in the client file, service manager, and reporting features.

+ Manage medical records; requests, distribution, ROIs, communication, etc.

+ Attend staff meetings, training and in-service as assigned by supervisor and/or as required by the agency;

+ Completes all orientation and mandated training activities, including E-Learning Courses, within required timeframes, and in accordance with the criteria established for this position.

+ Must embrace and embody the mission, vision, guiding principles, clinical vision, and goals of WestCare Foundation; and

+ Perform all other duties as assigned.

Qualifications

ESSENTIAL QUALIFICATIONS:

To perform this job successfully, an individual must be able to perform the duties and responsibilities satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required.

Experience and Competencies:

+ Excellent communication skills.

+ Ability to exercise good judgment and discretion.

+ Ability to work well in a team environment.

+ Adherence to the highest standard of ethical conduct, especially to standards governing confidentiality.

+ Professional appearance and demeanor.

+ Must be sensitive to populations served.

+ Valid driver’s license and ability to obtain and maintain WestCare’s vehicle insurance is required.

+ During your tenure with WestCare there may be new requirements, including, but not limited to vaccinations that are issued by local, State, Federal, and/or Funders that WestCare may have to comply with. Should this occur Human Resources or appropriate personnel will inform you.

EDUCATION and/or EXPERIENCE:

+ Training and/or experience in Crisis Intervention is preferred.

+ Two (2) years demonstrated recovery time from a significant mental health and/or substance abuse disorder at the date of application and within the last year either maintained at least 12 months of successful work or volunteer experience.

+ Familiarity with KY surrounding counties.

+ B achelor’s degree from accredited institution with previous demonstrated QA experience in behavioral health field preferred;

LICENSURE/CERTIFICATION:

+ Certified Recover Peer Specialists or Certified Recovery Support Specialist obtained within one (1) year of hire; preference will be given to candidates who are currently certified.

WORKING CONDITIONS:

+ Work is primarily performed in a professional office/residential setting.

+ Some outdoor activities may be required.

+ Some travel is required.

ESSENTIAL PHYSICAL AND MENTAL DEMANDS OF THE JOB:

The employee must be able to perform the following essential duties and activities with or without accommodation:

PHYSICAL DEMANDS:

+ Requires mobility and physical activity: Having an adequate range of body motion and mobility to work in an office, residential, or outdoor environment including standing and walking (even and uneven surfaces), sitting for extended periods of time, bending, twisting, reaching, balancing, occasional lifting and carrying of up to 10 pounds. Use of computer and telephone systems is required which includes coordination of eye and hand, and fine manipulation by the hands (typing, writing, and working with files). Requires the ability to defend oneself and clients in physically abusive situations using approved physical de-escalation techniques.

+ Requires talking: Expressing or exchanging ideas by means of the spoken word. Talking is required to impart oral information to employees, clients, patients, and the public, and in those activities in which the employee is required to convey detailed or important spoken instructions to others accurately, loudly, or quickly.

+ Requires hearing: Hearing is required to receive and communicate detailed information through oral communication.

+ Requires seeing: Clarity of vision at 20 inches or less and at distance. This factor is required to complete paperwork for many of the employee’s essential job functions and to observe client behavior and activities in and out of the facility.

The normal work routine involves no exposure to human blood, body fluids or tissues. However, exposure or potential exposure may be required as a condition of

employment. Appropriate personal protective equipment will be readily available to every employee.

Certifications/Licenses:

+ Ability to pass background clearance

Experience and Competencies:

+ Experience working with a substance abuse population is preferred;

+ Excellent language and interpersonal skills;

+ Knowledge of HIPAA regulations and guidelines;

+ Superior organizational skills and attention to detail; and

+ Strong computer skills, to encompass all Microsoft Office Platform Applications

+ Knowledge of electronic record keeping systems

Working Conditions:

+ Work is performed primarily in a professional, office setting, with some travel between specified facilities/locations required

+ A minimum of 40 hours per week are expected but additional hours may be required from time to time. Regular attendance is required.

Physical Demands:

+ Requires mobility and physical activity: Having an adequate range of body motion and mobility to work in an office, residential, or outdoor environment including standing and walking (even and uneven surfaces), sitting for extended periods of time, bending, twisting, reaching, balancing, occasional lifting and carrying of up to 30 pounds. Use of computer and telephone systems is required which includes coordination of eye and hand, and fine manipulation by the hands (typing, writing, and working with files). Requires the ability to defend oneself and clients in physically abusive situations through the use of approved physical de-escalation techniques.

+ Requires talking: Expressing or exchanging ideas by means of the spoken word. Talking is required to impart oral information to employees, clients, patients, and the public, and in those activities in which the employee is required to convey detailed or important spoken instructions to others accurately, loudly, or quickly.

Requires hearing: Hearing is required to receive and communicate detailed information through oral communication.

+ Requires seeing: Clarity of vision at 20 inches or less and at distance. This factor is required to complete paperwork for many of the employee’s essential job functions and to observe client behavior and activities in and out of the facility.

+ The normal work routine involves no exposure to human blood, body fluids or tissues. However, exposure or potential exposure may be required as a condition of employment. Appropriate personal protective equipment will be readily available to every employee.

Mental Demands:

+ Requires the ability to collect and analyze complex numerical and written data and verbal information to reach logical conclusions.

+ Requires the ability to work and cooperate with clients, co-workers, managers, the public and employees at all levels in order to exchange ideas, information, instructions and opinions.

+ Requires the ability to work under stress and in emotionally charged settings.

+ Requites the ability to be self-directed and performance/outcome driven; with limited supervisory or managerial oversight.

+ the ability to defend oneself and clients in mentally/verbally abusive situations through the use of approved mental/verbal de-escalation techniques.