Job Description
Job Description:\n\nPOSITION SUMMARY The Quality Assurance Specialist is responsible for assisting in the development, implementation, monitoring, and evaluation of the Agency's Quality Assurance, Regulatory Compliance, Risk Management, and Continuous Quality Improvement programs to ensure services are delivered in accordance with OPWDD regulations, OMIG requirements, Medicaid standards, Agency policies and procedures, and all applicable federal and state regulations. The Quality Assurance Specialist conducts comprehensive audits, compliance reviews, program observations, record reviews, environmental assessments, and regulatory monitoring activities across Residential Services, Certified Day Habilitation, Day Habilitation Without Walls, Community Habilitation, Respite Services, Supported Employment (SEMP), Pre-Vocational Services, Nursing Services, Transportation, Maintenance, Human Resources, Records Management, and other Agency departments to evaluate operational performance, identify areas of regulatory risk, verify compliance, and promote high-quality, person-centered services. The Quality Assurance Specialist collaborates with Executive Leadership, program leadership, clinical departments, and interdisciplinary team members to identify compliance concerns, monitor corrective actions, provide technical assistance, support survey readiness, and promote continuous quality improvement throughout the Agency. The Quality Assurance Specialist conducts internal audits, unannounced program reviews, mock surveys, documentation reviews, environmental inspections, medication observations, active treatment observations, transportation reviews, and other quality monitoring activities to ensure individuals receive safe, effective, person-centered services while assisting departments in maintaining regulatory compliance, improving operational performance, reducing organizational risk, and achieving quality outcomes. REQUIRED KNOWLEDGE, SKILLS, AND ABILITIES Employee must possess the ability to interact professionally and ethically with individuals receiving services, families, Agency leadership, supervisors, managers, Program Coordinators, Residential Managers, clinical professionals, Direct Support Professionals, regulatory agencies, community partners, and interdisciplinary team members while maintaining objectivity, professionalism, and confidentiality. Must possess comprehensive knowledge of OPWDD regulations, OMIG requirements, Medicaid standards, HIPAA, Corporate Compliance, Incident Management requirements, Quality Assurance principles, and all applicable federal and state regulations governing services for individuals with intellectual and developmental disabilities. Must possess knowledge of quality assurance methodologies, regulatory compliance, internal auditing, risk assessment, corrective action planning, root cause analysis, active treatment principles, person-centered planning, documentation standards, incident management, infection prevention, medication administration requirements, fire and life safety standards, emergency preparedness, environmental safety, and continuous quality improvement principles. Knowledge of Life Plans, Staff Action Plans, Behavior Support Plans, Plans of Nursing Services (PONS), PrecisionCare documentation, billing documentation, clinical records, and other OPWDD-required documentation is required. Ability to conduct comprehensive audits, documentation reviews, program observations, interviews, compliance assessments, mock surveys, environmental inspections, medication room reviews, transportation reviews, and regulatory monitoring activities while accurately identifying deficiencies, determining compliance risks, evaluating systemic concerns, and recommending corrective actions. Ability to prepare professional audit reports, exit conference summaries, corrective action recommendations, statistical reports, trend analyses, executive summaries, and other quality assurance documentation using objective, factual, and professional language. Ability to interpret and apply Agency policies, OPWDD regulations, OMIG requirements, Medicaid standards, and regulatory guidance while exercising sound judgment, maintaining confidentiality, prioritizing multiple assignments, meeting strict deadlines, and managing sensitive information. Ability to utilize Microsoft Office applications, PrecisionCare, electronic health records, audit software, databases, reporting systems, and other technology necessary to perform Quality Assurance, regulatory compliance, auditing, and reporting functions. Ability to communicate effectively both verbally and in writing, provide technical assistance and coaching, conduct exit conferences, present audit findings, educate staff regarding regulatory requirements, and establish collaborative working relationships with Agency leadership, program staff, regulatory agencies, and interdisciplinary team members. Ability to travel to al