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Company

Original Job Post

Zufall Health · 2 days ago

Quality Assurance Specialist

Morris County, NJ

Full-time

Onsite

Entry, Mid Level

2+ years exp

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Responsibilities

Assist in preparing and monitoring performance reports, and conducting continuous data reviews across various programs, including UDS, Board reports, and grant-funded projects.

Support the maintenance and updating of Policies & Procedures.

Help ensure compliance, maintenance, and renewal with accreditation standards, including Joint Commission accreditation and NCQA’s PCMH accreditation.

Participate in the QA/PI/RM Committee, aiding in meeting preparations and minute-taking.

Assist in the implementation and management of QA projects and initiatives such as Wise Woman, SMBP, and various health-related grants.

Act as a liaison for HealthEfficient, Relevant, and other data collaborators.

Aid in maintaining AHA Recognitions and ADCES/DSMES Accreditation by compiling and submitting necessary data.

Serve as the liaison between Zufall, health plans, and Atlantic Health System’s ACO, facilitating effective communication and collaboration.

Assist in data gathering and reporting for Atlantic Health System’s ACO and requests received from health plans regarding HEDIS measures and other required metrics.

Conduct periodic meetings with health plans and ACO to address care gaps, analyze incentive payment data, audit charts per HEDIS standards, and report findings.

Educate teams on current incentive requirements and develop streamlined processes for compliance and contribute to the enhancement and implementation of value-based care.

Support the enhancement, development and expansion of QA processes, including regular assessments and reviews in various departments/domains, such as, Behavioral Health, Dental, Perinatal Health and Ryan White program.

Engage in data aggregation, mining, analysis, and validation to pinpoint areas for improvement.

Support the conversion of data into actionable insights, including data gathering, analysis, and presentation.

Collaborate with data analysts and IT to ensure accurate reporting of services, supporting the maintenance of reports for compliance with regulatory requirements and assist in maintaining Tableau and other data reports ensuring data integrity.

Review and support the enhancement of data collection systems.

Provide assistance and training to staff on documentation and data entry practices.

Adhere to HIPAA standards for information confidentiality.

Performs other related duties as assigned by their supervisor.

Qualification

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Ambulatory CareQA/PI ActivitiesRN LicenseNJ

Required

Bachelor’s degree in related field required, Master’s degree preferred.

Minimum 2 years experience in an ambulatory care setting as a clinical staff or relevant experience in a clinical setting.

Minimum 2 years experience performing QA/PI activities.

If RN, valid, current license in NJ.

Benefits

Health Insurance

Company

Zufall Health

Founded in 1990, Zufall Health is an award-winning, nonprofit, state-licensed community health center that provides access to high-quality, affordable medical, dental, and behavioral treatment to people and communities who experience barriers to care.

Founded in 1990

Dover, Delaware, USA

201-500 employees