Quality Specialist
Position Summary Education: Bachelor’s degree in a health-related field required. Competencies Desired Experience in healthcare quality, compliance, care management, person-centered care services, and/or social service program oversight. Understanding of documentation standards, case review methodologies, and quality monitoring practices. Ability to conduct audits using internal tools and external audit instruments (e.g., health plan and state tools), analyze findings, and communicate results. Ability to identify service quality gaps and support development of corrective actions and quality improvement interventions. Strong written and verbal communication skills, including the ability to provide professional, constructive feedback. Sound judgment in reviewing clinical and non-clinical issues and escalating concerns appropriately. Strong organizational skills and ability to maintain accurate records, track follow-up actions, and meet deadlines. Cultural competence and ability to communicate effectively with individuals from diverse backgrounds. Quality Assurance Strategy Support implementation of a comprehensive quality assurance strategy aligned with state, health plan, and internal standards. Conduct case reviews and audits using internal quality tools and state/health plan-provided audit tools to evaluate service quality, documentation, and compliance. Identify trends, recurring gaps, and opportunities for improvement, and communicate findings to leadership and program teams. Support monitoring of high-risk or priority quality concerns and escalate issues in accordance with internal procedures. Contribute to development and refinement of quality monitoring tools, dashboards, and reporting processes. Quality Oversight Support audit readiness and compliance activities, including file review, standards interpretation, and policy/procedure development or revision. Serve as a subject matter resource on program quality and compliance standards, including state, health plan, and internal policy requirements. Assist with implementation and reinforcement of policies, procedures, and documentation standards across teams. Provide audit feedback and compliance guidance to staff and supervisors to promote consistent adherence to requirements. Participate in interdisciplinary meetings and quality-related workgroups as assigned. Quality Improvement Initiatives Assist in development and implementation of quality improvement interventions to address identified gaps in service quality and compliance. Track audit findings and performance trends to support targeted improvement efforts and follow-up monitoring. Support corrective action planning and progress tracking related to audit findings and quality concerns. Monitor key quality indicators and assist in reporting progress on quality improvement activities. Documentation, Reporting, and Quality Systems Maintain accurate records of audit activities, findings, corrective actions, and quality improvement follow-up. Prepare routine and ad hoc reports summarizing audit outcomes, trends, and improvement activities for leadership and stakeholders. Enter and maintain quality review data in internal databases, dashboards, and electronic systems. Support ongoing improvement of audit tools, tracking systems, and reporting processes. Partners in Care Foundation is an equal opportunity employer. We are committed to complying with all federal, state, and local laws providing equal employment opportunities, and all other employment laws and regulations. It is our intent to maintain a work environment which is free of harassment, discrimination, or retaliation because of age, race (including hair texture and protective hairstyles, such as braids, locks, and twists), color, national origin, ancestry, religion, sex, sexual orientation, pregnancy (including childbirth, lactation/breastfeeding, and related medical conditions), physical or mental disability, genetic information (including testing and characteristics, as well as those of family members), veteran status, uniformed service member status, gender, gender identity, gender expression, transgender status, arrest or conviction record, domestic violence victim status, credit history, unemployment status, caregiver status, sexual and reproductive health decisions, salary history or any other status protected by federal, state, or local laws. All qualified applicants will receive consideration for employment and reasonable accommodations may be made to enable qualified individuals to perform the essential functions of the position.
