Quality Specialist, PACE

Quality Specialist At McGregor PaceMcGregor PACE (Program of All-inclusive Care for the Elderly) is a community-based service program that provides in-home healthcare services to the elderly as an alternative to nursing home placement, allowing seniors to remain at home. As a Quality Specialist at McGregor PACE, this role is responsible for assisting in maintaining accurate records for all aspects of quality and quality improvement. Provides data analysis for various aspects of the PACE program. Responsibilities: Responsible for tracking all participant incidents and reporting to the appropriate regulators. Gain knowledge and understanding of the PACE Manual and PACE regulations. Performs monthly audits of all falls within the Electronic Medical Record as directed by Quality Director. Responsible for tracking Emergency Room visits for participants and reporting to the appropriate regulators. Assists in the reporting of PACE Quality Monitoring Data (with and without root cause analysis to ODA and CMS). Oversees the Service Determination Request (SDR) process including tracking, monitoring, and auditing all requests as well as facilitating all SDR meetings. In addition to SDR, the Quality Specialist will oversee appeals and grievances procedures. Routine audits of the Electronic Health Record including critical events and level of care assessment compliance. Assists in the creation and submission of various reports monthly, quarterly, and on an as-needed basis. Assists the Quality Director in data collection, creation, and implementation of Quality Improvement projects for the organization. Minimum Qualifications: Must be fluent in Microsoft applications including Windows, Word, and Excel, and Outlook. Excellent customer service and organizational skills required. Strong verbal and written communication skills required. Ability to read and interpret documents, ability to write routine reports. Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Data Collection and analysis, preferred. Previous experience in healthcare, preferred. Experience in quality, preferred. We offer competitive compensation andEXCELLENT BENEFITSwhich include: Health Insurance HSA Dental Vision 403b Matching Retirement Plan Employer Paid Life Insurance Voluntary Life Coverage Short- and Long-Term Disability Critical Illness & Accident Coverage PTO Sick Time 6 Paid Holidays