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- Responsible for recruiting, supervision, performance review, discipline of staff as assigned by Director. Depending on the nature or type of department, office, program or unit, this may include, but is not limited to; Data Analysts, Reviewers, Authorization Specialists and Clerks.
- Performs and/or oversees regular chart audits, record keeping, and other reporting and documentation functions as assigned to ensure that all records are maintained in accordance with all applicable TTC policies, procedures, and external regulations and standards to include but not limited to Joint Commission, State, County, City sources.
- Completes or participates in the development and submission of various reporting requirements as assigned. Such reporting may include Continuous Quality Assurance reports, various performance improvement reports and data reports of various types.
- Supervises, and performs, when necessary, regular internal audits for DMC, DMH, and Private Insurance to reduce denials based on data and clinical documentation.
- Drafts and presents regular reports to the Risk Management and other assigned committees to report on results of internal audits and corrective actions.
- Attends in-service training and educational workshops.
- Attends all required staff meetings.
- Conducts self in a professional manner in areas of dress, language, attitude and behavior. At all times is a role model for other staff and patients.
- Exhibits full knowledge and support of the philosophy and objectives of the Agency.
- Fully understands and maintains policies regarding professional ethics, including appropriate boundaries and patient confidentiality.
- Utilization review activities, as required.
- Conducts or participates in performance evaluations of interns and other staff, as required.
- Attending clinical and administrative committee meetings, as requested.
- Participating in community events, presentations, meetings, and outreach on behalf of TTC.
- Performs other related duties as assigned by CEO, Director of Information Technology or QA Supervisor.
- Manages data and reporting related to reconciliation for denied authorizations from County funding sources and communicates with program staff to reverse denials to maximize revenue for the Drug Medi-Cal contract.
- Utilizes data obtained from internal audits to identify and develop trainings to meet and maintain accreditation standards.
- Supervises and monitors clinical Joint Commission standards to ensure compliance is maintained.
- Works with the Training Department to design and implement agency-wide trainings to address repeated internal and external audit findings.
- Ensures integrity of documentation that supports medical necessity and care decisions via retro chart reviews.#J-18808-Ljbffr
Quality Assurance Supervisor - Los Angeles, United States - Tarzana
Description
POSITION SUMMARYResponsible for improving organizational performance to include compliance with quality standards established by Joint Commission, NCQA, and the public and private sector organizations with which Tarzana Treatment Centers (TTC) contracts.
collecting, evaluating, and preparing statistical data to support activities of the agency.
Develops, maintains, and ensures quality control of agency's databases in coordination with other departments for management decision-making and reporting purposes.
Develops and implements strategies to monitor and improve TTC's success in achieving its mission to improve quality of care, improve patient experience, and reduce the total cost of care.
HOURS8 per day / 5 Days per Week / SalaryCATAGORIES OF DUTIESEXPERIENCEMinimum of one (1) year experience in evaluating and/or treating persons suffering from substance abuse and/or dual diagnosis. Minimum of one (1) year experience in quality improvement, research, project evaluation, data management and/or program development. Prior supervisory experience.
Addendum for Data Supervisor