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Quality Assurance Auditor
The Center for Urban Community Services (CUCS) and its affiliate, Janian Medical Care are nationally-renowned human services organizations. Together they provide supportive housing, psychiatric care, primary medical care and related services to thousands of homeless, formerly homeless and low income individuals in more than 50 settings across New York City. With approximately 475 staff and an annual operating budget of over $62 million, CUCS and Janian work to foster a learning culture, continually evaluating our programs to ensure that we deliver the highest quality services to the New Yorkers whom we serve. For the quality and depth of their work, CUCS received the inaugural New York Times Nonprofit Excellence Award for Sustained Impact, and Janian recently won the American Psychiatric Association Gold Award for innovative service delivery.
The Quality Assurance Department develops, implements, and maintains agency wide processes and structures that ensure program quality, contract compliance, Medicaid compliance, and the continuous improvement of the agency’s services.
The Quality Assurance Auditor is responsible for conducting a variety of internal audits according to a schedule developed by the Quality Assurance Department.
1. Conduct comprehensive chart reviews at various program models using various auditing models including tracer audits
2. Generate and review a variety of reports through multiple EMRs and databases in support of monitoring compliance
3. Conduct utilization review assessments
4. Conduct retrospective, concurrent, and prospective claims audits assessing both technical and clinical aspects of claims in order to ensure they are compliant with State and Federal regulations and with CUCS expectation of good care
5. Conduct fidelity scale reviews for evidence based practices as assigned
6. Other audits as assigned
7. Provide reports, findings and recommendations to various stakeholders about compliance
8. Monitor and track the implementation of corrective action plans
9. Identify staff training needs through auditing activities
10. Provide technical assistance and training to programs and staff around compliance and quality of care issues and identified training needs
11. Assist in the development of policies and procedures related to auditing and compliance
12. Special projects as assigned
13. Attend meetings
This position reports to the Compliance Manager.
Experience and Education Required:
• Licensed Social Worker
• Strong written and verbal communication skills
• Computer literacy, including strong skills in Excel
• Experience with electronic health records
• Strong attention to detail
Licensed Clinical Social Worker
Posted on 12/14/17; CVMHA ID #11672