Quality Assurance Manager - Home Care

6 days ago

🤠 Texas – Remote

Although this job is listed in Texas, this company may be open to hiring remote in other states.

⏰ Full Time

🟡 Mid-level

🟠 Senior

🔧 QA Engineer (Quality Assurance)

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Addus HomeCare

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Addus HomeCare is a provider of quality in-home supportive services that enable individuals to maintain their health and independence while remaining in their homes. With over 40 years of experience, Addus offers a range of services including in-home care, home health, and hospice care to patients across various states. Their dedicated caregivers focus on providing compassionate support tailored to the unique needs of each individual, ensuring comfort and confidence for patients and their families.

Personal Care Services • Private Duty • Veterans'​ Benefits Home Care • Preventative Home Care • Homemaker Services

10,000+ employees

Founded 1979

⚕️ Healthcare Insurance

📋 Description

• Reporting to the Vice President of Quality Assurance, the Regional Quality Assurance Manager is responsible for facilitating and assuring in home care service billing is compliant with applicable Medicaid, Medicaid waiver, MCO, and other licensure and contractual requirements throughout all Addus personal care locations. • This is remote position and the person will rarely be expected to travel. • This position will primarily focus on billing audits. • Investigate and respond to requests for billing audits and recoupments from payers by reviewing records and documentation. • Develop, review, revise and implement standardized state specific policies, procedures and work processes that comply with Medicaid and other regulatory/contractual payer agreements. • Educate branch leadership and staff on state regulatory and contract requirements. • Perform desktop audits and monitoring to assess branch level compliance with applicable rules and regulations. • Oversee and support external agency audit processes including audit preparation, deficiency remediation and corrective action planning. • Monitor corrective action execution and drive accountability. • Drive operational compliance and quality outcomes. • Report internal and external audit findings at all levels including branch, regional and senior leadership. • Facilitate investigation, reporting and resolution of incidents and complaints related to billing practices. • Performs other duties as assigned.

🎯 Requirements

• Bachelors Degree in Business, Social Services, Public Administration, or a related field of study • 3-5 years of experience in health care, social services or a related industry • Audit experience is strongly preferred • Some experience in a large, fast-paced, results-driven, multi-site organization • Must possess strong communication, written, interpersonal and organizational skills • Proficiency in using Microsoft Word, Excel, PowerPoint and Outlook, required.

🏖️ Benefits

• Medical, Dental and Vision Benefits • Continued Education • PTO Plan • Retirement Planning • Life Insurance • Employee discounts • Company matched 401K