Assistant Quality Assurance Director

Aspire Behavioral Health & Developmental Disabilities Services Job Description

 

A. ORGANIZATIONAL RELATIONSHIPS

 

Position Title: Assistant Quality Assurance Director

Position Number:

 

Date:                

Employee:

 

Work Unit: AACSB Administration County: Dougherty

Immediate Supervisor's Title: Revenue Cycle Management Director

 

List positions supervised through immediate contact: None

 

B. QUALIFICATIONS:

 

Knowledge of agency specific office procedures and methods.  Computer Skills. Ability to maintain routine clerical records.  Ability to establish, maintain and update an organized, accessible filing, mailing, or inventory system.  Ability to communicate effectively both orally and in writing.  Ability to understand and interpret written materials.  Ability to perform basic bookkeeping and banking transactions.  Ability to prepare all related reports.  Ability to use agency specific software.   Knowledge of basic English and grammar usage. Ability to perform basic bookkeeping and banking transactions.  Ability to prepare all related reports.  Ability to operate all office machines.  Ability to order supplies at all necessary times.

 

 (Physical) No lifting of more than 20 pounds.

 

C. EQUIPMENT THAT REQUIRES SAFE AND EFFECTIVE USE:

 

(Include emergency equipment, treatment equipment and high risk equipment)

 

D. BL00DBORNE PATHOGEN CATEGORY (check one)

 

____Employee routinely performs tasks that involve exposure to blood or other potentially infectious

material as part of their assigned duties (Category I).

____Employee performs assigned tasks which does not involve exposure to blood or other

potentially infectious matter, BUT employment may require performing unplanned category I tasks

(Category II).

 

X    Employee performs assigned tasks which involve no exposure to blood or other potentially

infectious material AND performance of category I tasks are not a condition of employment

(Category Ill).

 

E. MANDATORY TRAINING CATEGORY (Check One)

 

_X__Administrative

_____

____Direct Care

_____

____Medical

 

.

ALBANY AREA CSB Job Description                                                                         Page 2

 

Position Title: Assistant Quality Assurance Director

Position Number:

 

 

F. PERFORMANCE IMPROVEMENT

 

The Albany Area Community Service Board goal is to continually improve the delivery of service

by improvement of consumer outcomes and satisfaction. All employees have a role in performance

Improvement and are expected to interact collaboratively with co-workers, and other contacts to

provide consistent, high-quality, consumer focused services

 

G.  ASSIGNED DUTIES

 

Performs a variety of clerical support functions/processes for an office or unit.  Performs clerical duties, or a few specialized or essential clerical functions.  (i.e data maintenance, filing system maintenance, transaction etc.)

 

Duties Include:

 

60%     Provides Quality Assurance service direction and assistance to the clinical units within the agency. Manage and track QA processes within the agency including:

• Back up to QA Director with 5% Audit tracking and reporting
• Back up to QA Director with Psych peer reviews tracking and reporting
• Assist with Fidelity implementation, review and tracking
• SOR II system administrator
• Assist with new NPI and MCD numbers for sites as needed
• Verification of staff credentials internally and externally (ie: insurance panels etc)
• Point of contact for Beacon in reference to batch files including authorization and discharge in the absence of QA Director
• Assist QA Director with testing and implementation of all new enhancements to system
• Conducts or participates in the development, review, revision, interpretation, and/or implementation of policies, procedures, standards, and guidelines

 

25%     Coordinates  UM staff.

• Performs Utilization duties by tracking failed activities, rejected authorizations and facilitating corrections/compliance for all units in the service area. Reporting is sent weekly to individual staff for corrections.  Then sent to administration following failure to comply in established timeframes. 

• Verifies batches and loads authorizations, rejections and denials.
• Resolves rejections and denials in a timely manner. Rejections and denials will be worked within 5 business days.
• Ensures all errors with service delivery/documentation (failed activities) and authorizations (pends, rejections, denials, incomplete) are rectified within the established timeframes to enable full payment.
• 100% of all QI/UM reporting requirements completed within required time frames.  Goal is to have services cleared for claim submission within 30-days of service delivery.

 

 

10%     Coordinate staff training needs. To include:

• All UM staff remaining in compliance
• Orientation and updates for Clerical
• Monthly updates for management team and leadership
• Ongoing assistance for agency with remaining in compliance with service guideline standards
• Updates to EMR system and rollout

 

4%       Attend agency required training; meetings as scheduled by supervisor.

 

1%       other duties as assigned, not to exceed 90 days, as assigned by supervisor. Will keep up with essential learning to perform assigned work.  

 

 

NOTE:  This position will answer directly to the Revenue Cycle Management Director

 

Position Title: Assistant Quality Assurance Director