Quality Management Analyst

Description

Company name: PCA Care Connections

Title of position: Quality Management Analyst

Position type: Full Time

Pay range: $55,022.23 - $63,695.11 varies with experience.

Location: PCA Main Building

THE ORGANIZATION

"PCA Care Connections is a NCQA accredited non-profit agency that currently provides two types of services: Service Coordinator for Community Health Choices (CHC) participants enrolled with Pennsylvania Health and Wellness and Nursing Home Transition Services for participants enrolled with Pennsylvania Health and Wellness or Keystone First. We currently serve participants throughout the Greater Philadelphia region, including Philadelphia, Delaware, Montgomery, Bucks and Chester counties.”

" The mission of PCA Care Connections is “provide high quality, person-centered and cost effective Service Coordination for older adults and persons with disabilities in partnerships with managed care organizations and integrated health systems and practices. Our goals are to promote quality of life, independence, dignity, and optimal health and well-being.”

Benefits:

• Medical, prescription drug, vision, and dental coverage
• Flexible spending plan (health and dependent care)
• EAP, life insurance, short- and long-term disability      insurance
• Pre-tax commuting, and parking benefits
• Annual paid time off and vacation are based depending      on tenure. 

Requirements

Description of Role: Reporting to the PCACC Deputy Director (DD), this position is responsible for evaluation and recommendations to ensure and improve service coordination (SC) performance regarding PCA CC standards and regulatory compliance.

Required Education: MSW or related degree

Required Experience: 

• Minimum of 3-5 years of clinical and administrative experience in social services
• Knowledge and experience in Continuous Quality Improvement

Job Responsibilities: FULL Job Description will be available

a. Conducts ongoing monitoring and analysis of quality standards and compliance indicators for service coordination in PCA CC.

b. Conducts MIS System record audits using standardized instruments and reports to assess accuracy and timeliness of SC activity, documentation, and compliance with quality metrics.

c. Actively participants in all aspects of maintaining the agency’s NCQA Long-Term Care and Supports Care Management accreditation.

d. Provides feedback from audits and makes recommendations in collaboration with PCA CC management to modify internal processes, enhance training, and/or address individual performance issues.

e. Serves as PCA CC Point Person for critical incidents for CHC-MCO and monitors critical incident compliance.

f. Assists with the development and review of policies, procedures, tools, and resources to support staff in meeting CHC-MCO and NCQA requirements.

g. Maintains productive relationship with stakeholders, agencies, and organizations.

h. Other duties as assigned.

Professional Characteristics: 

• High energy level; able to manage a variety of tasks simultaneously.
• Well-developed interpersonal and communication skills.
• Well-developed organizational and problem-solving skills.
• High level of flexibility.
•  Strong computer skills including experience with Excel 
•  Able to function independently

For information on PCA Care Connections, including more information on our company culture, visit our website at https://www.pcacareconnections.org/

All applicants will receive an acknowledgement that their application has been. Those candidates selected for further consideration will be contacted.

PCA Care Connections is an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.