QA Reviewer

QA Reviewer Job DetailsJob LocationUtica - Utica, NY About Us: Live the Life YOU Want to Live Telecommuting Opportunity LIFEPlan CCO NY, LLC. empowers people with intellectual and developmental disabilities, and their families to lead happy, healthy and meaningful lives through choice, inclusion and participation. LIFEPlan supports the members we serve to dream, plan and achieve their goals, and to Live the Life They Want to Live. In turn, we offer a competitive compensation package, generous benefits and paid-time off, comprehensive on-going training, promotion opportunities and a work culture that values commitment, excellence, work life balance, teamwork, respect and dignity to support our staff to live their best lives. The QA Reviewer will stay abreast of current regulations, policies and procedures to support the field. This position will meet specific objectives in terms of the number of reviews conducted and provide corrective action/follow up as appropriate. Completes assigned projects and initiatives for the QA Department- e.g., compiling of data relating to audit reviews for Life Plans, progress notes, and other documentation as well as other QA related needs. Actively utilizes QA systems including internal monitoring systems while adhering to the regulatory guidelines to ensure the highest quality standard is promoted internally. ESSENTIAL FUNCTIONS Understands and applies governmental laws and regulatory rules; keeps current on trends Reviews progress notes, LIFEPlans, and other documentation daily Applies sound auditing practices as assigned, complies with regulations, laws, and LIFEPlans program policies, and procedures: Works in conjunction with the field, makes recommendations for resolution of issues, supports best practices as determined by agency leadership. Meets auditing objectives Maintains all documents, files, and records ensuring they are complete and secure, Utilizes required databases to enter information timely, accurate, completely Protects the rights of individuals served and make sure informed consent measures are adhered to Consult with employees on issues Participates on committees, in meetings, and presentations as assigned Prepares letters, memoranda, statements, narratives, statistical reports and agendas as requested or according to established procedures, including when redaction is required/recommended Manages and implements projects assigned by the Director of QA, Director Participates in special projects and all other job-related tasks as assigned by the QA Director or Manager. Bachelors degree is required, Human Services, Health Care Management majors are preferred Graduate degree (Masters, Doctorate) preferred Specialized training, license, certification, skills in: OPWDD and DOH regulations Auditing against regulations and best practice Report Writing At least 3 year of job-related experience, specifically in OPWDD, DOH, and quality assurance programs and policies. Ability to communicate with a wide variety of individuals including professionally, intelligently, and effectively, verbally and in writing (including email, reports, memos, policies) to representatives of government agencies, all levels of LIFEPlan staff and individuals and families/advocates. Requires strong telephone and customer service skills. Ability to determine what the request is being made and the course of action in a calm, reassuring, and polite manner. Cross organization communication on a regular basis, including controversial problems within and outside of the organization and presenting recommendations for resolutions. Basic math skills. Strong working knowledge of regulatory websites and databases. Proficiency in MS Word, PowerPoint and Outlook. Position constantly requires independent thought and reasoning. Ability to interpret complex information. Ability to obtain facts and exercise judgment in interpreting the facts presented. Must be able to analyze and identify trends and systemic problems with programs. Ability to work on several projects simultaneously and independent of supervision. Knowledge of applicable State/Federal laws and regulations e.g., OMRDD, DOH, OCFS, Justice Center. Knowledge of investigation techniques, quality improvement literature, tools, procedures, programs. Must have strong knowledge of all regulations governing the area of incident reporting and abuse. Demonstrated knowledge of quality improvement literature, tools, and systemic problem-solving methods Working Environment: Flexible work hours Will have pressure due to time deadline and volume of work. Must possess ability to work independently and autonomously. Must be able to reprioritize job tasks with limited notice. Problem Solving: Requires independent judgment, creativity and resourcefulness. Ability to analyze complicated situations and apply principles in developing solutions. Decision Making: Authorized to take any reasonable action necessary to carry out assigned responsibilities consistent with company policy, laws, and regulations. Demonstrates reliability in decision-making and understands the consequences of actions. Anticipates problems and presents solutions. Must have the skills and ability to advise staff at various levels on a variety of issues and concerns. Makes decisions in a collaborative and persuasive manner, in conjunction with the QA Manager.

Created: 2025-11-15