Rusk, TX 75785
$4,301 - $7,040 a month - Full-time

Full Job Description

The Quality Assurance Specialist IV is selected by and reports to the Quality
Assurance Manager for Long Term Care Regulation. The Quality Assurance
Specialist is responsible for overseeing the planning, development, and
administration of internal quality assurance and compliance activities. Work
includes appeal processing, performance management, and reviewing, analyzing
and evaluating investigations to determine compliance with federal, state, and
program requirements. May supervise the work of others. Works under minimal
supervision, with extensive latitude for the use of initiative and independent
judgment.


Essential Job Functions:
Coordinates the timely and ongoing transmittal of completed assignments. •Provides technical guidance and assistance to field staff. •Completes and documents quality assurance reviews and communicates those findings to appropriate program staff. •Analyzes quality assurance findings and performance data to identify trends or patterns. •Coordinates case readings and other quality assurance and developmental activities. •Evaluates success of the current processes, best practices, and leads the implementation of changes where improvements must be made. •Reviews trends and resolves problems regarding the methods of quality assurance operations or procedures. •Develops and conducts staff training as new program policies and procedures are implemented or new programs are mandated. •Prepares reports and maintains accurate records of operations. •Communicates and coordinates effectively with all levels of program and agency staff, other state agencies, external stakeholder groups, and various other organizations. •Represents the program at meetings, hearings, trials, conferences and seminars or on boards, panels and committees. •Performs related work as assigned.


Knowledge Skills Abilities:
Knowledge Skills Abilities:
Knowledge and experience in HHSC Provider Investigations. •Knowledge of federal and state laws, rules, program, and policies applicable to HHSC Provider Investigations. Knowledge of performance management and continuous quality improvement processes. Skill in managing multiple and competing priorities. •Skill in critical thinking to identify problems, evaluate alternatives, and recommend effective solutions. •Skill in evaluating trends and patterns in abuse, neglect and exploitation investigations. •Skill in use of personal computer and various software programs to include Word, Excel, PowerPoint, and Outlook. •Ability to gather, assemble, correlate, and analyze facts; to prepare concise reports. •Ability to accurately research, interpret, and apply pertinent statutes, rules, policies and procedures. •Ability to communicate effectively both orally and in writing. •Ability to present to large groups. •Ability to build, establish, and maintain effective working relationships with diverse individuals and groups.

Registration or Licensure Requirements:
NONE


Initial Selection Criteria:
Experience with HHSC Provider or Long Term Care Regulatory Investigations in a full-time supervisory role, or at minimum, 18 months experience (24 months preferred) conducting investigations as an HHSC Provider or LTCR Investigator. Graduation from a four-year college or university.