A class incumbent is responsible for administering the Quality Assurance/Risk Management/Utilization Management Program in a state-owned facility such as a nursing home, psychiatric treatment or developmental disability facility.
Nature and Scope
An incumbent in this class reports to an administrative superior. The class incumbent develops, implements and oversees all quality assurance activities and monitors program policies and procedures necessary to implement the program. A significant aspect of the work involves providing consultation and technical assistance to all levels of facility staff on matters relating to implementation of quality assurance standards and compliance with same. A class incumbent is responsible for monitoring and analyzing the quality and appropriateness of facility services and functions and may conduct special studies as requested.
Essential functions are fundamental, core functions common to all positions in the class series and are not intended to be an exhaustive list of all job duties for any one position in the class. Since class specifications are descriptive and not restrictive, incumbents can complete job duties of similar kind not specifically listed here.
Manages the quality assurance program which may include infection control, risk and utilization management programs.
Ensures facility activities/operations conform with programmatic policies and procedures, applicable standards and federal/state regulatory requirements.
Coordinates the facility remediation program for Quality Assurance; Reviews data from incident reports on accidents/injuries as it relates to facility wide Quality Assurance.
Maintains the master schedule of Quality Assurance activities within the facility.
Gathers and analyzes data through audits, interviews and other activities in order to monitor the quality and appropriateness of services and functions.
Designs tools, systems and methodologies for data collection and recommended action. Prepares reports of findings and recommended action.
Investigates incidents of non-compliance and allegations of abuse, neglect and mistreatment of patient, and conducts special studies as requested by superiors.
Recommends new/revised operational or administrative policies/procedures to maintain proper utilization of services and reduce facility liability.
Chairs and coordinates internal quality assurance committee.
Participates in other facility committees which impact the Quality Assurance Program.
Develops and conducts educational programs for and provides technical assistance to facility staff in all aspects of quality assurance.
Acts as a liaison with other agencies and external reviewers associated with quality assurance.
May supervise the work of professional, technical and/or support staff assigned to the program.
Knowledge, Skills and Abilities
The intent of the listed knowledge, skills and abilities is to give a general indication of the core requirements for all positions in the class series; therefore, the KSA’s listed are not exhaustive or necessarily inclusive of the requirements of every position in the class.
Knowledge of principles of management and administration.
Knowledge of facility programs, policies and procedures.
Knowledge of patient care standards.
Knowledge of State and Federal statutes impacting licensure, life and safety codes, and health care services.
Knowledge of the nursing process, practices and techniques.
Knowledge of methods and techniques used in the analysis of managerial and operational problems.
Knowledge of statistics and their use as an analytical and evaluative tool.
Knowledge of quality assurance, risk management, utilization management programs.
Skill in problem-solving techniques.
Ability to provide leadership and set priorities.
Ability to communicate with professional and non-professional employees.
Ability to develop and coordinate training programs.
JOB REQUIREMENTS for Quality Assurance Administrator Applicants must have education, training and/or experience demonstrating competence in each of the following areas:
Possession of a Bachelors degree or higher in Behavioral Science, Social Science, Health Science, Business or related field.
Three years experience in quality improvement which includes evaluating the quality of services, identifying problems and needs and recommending corrective action and improvements to ensure optimum service delivery, goals and objectives are met and ensure compliance with applicable laws, rules, regulations and standards.
Three years experience in ensuring compliance with regulatory and accreditation standards for health care facilities.
Six months experience in developing policies or procedures.
Knowledge of inferential statistics such as correlation, t-tests, f-tests or analysis of variance.
Knowledge of descriptive statistics such as the mean, median, mode or standard deviation.