Quality Assurance Case Review Specialist

• Base Pay $27.25 - $32.75 / Hour
• Employee Type Non-Exempt - Full Time

Contact information

• Name HR Department

Job Title: Quality Assurance Case Review Specialist

Department: Financial Assistance

Reports To: Quality Assurance and Training Manager

Supervises: None

FLSA Status: Non-Exempt

Pay Grade: N5

Job Type: Regular, Full-Time

AKBCU: No ICPA: Yes

The Quality Assurance Case Review Specialist ensures data integrity and service quality across financial assistance programs by conducting comprehensive case file reviews and analyzing program compliance. This position plays a critical role in maintaining CITC's high standards by evaluating the timeliness and accuracy of eligibility determination and case management processes. Working in partnership with our people, the specialist develops opportunities that fulfill our endless potential through continuous quality improvement, trend analysis, and staff training.

The role directly supports CITC's mission by ensuring that financial assistance services meet regulatory requirements and organizational values while providing exceptional support to Alaska Native and American Indian participants.

• Conduct comprehensive eligibility and case management quality assurance case file reviews to ensure compliance with established standards, protocols, and CARF requirements.
• Monitor data integrity and accuracy within financial assistance databases to ensure alignment with CITC, CARF, and funding performance requirements.
• Analyze case documentation to identify discrepancies, document trends, and provide recommendations for process improvement and error mitigation.
• Develop and implement training on regulations, policies, procedures, and best practices for financial assistance staff.
• Support Senior Director and Program Managers with development of monthly, quarterly, and bi-annual grant reports and performance metrics.
• Collaborate with cross-functional teams to address quality issues, implement corrective actions, and enhance overall program effectiveness.
• Maintain comprehensive documentation of quality assurance processes, findings, and improvement initiatives.
• Generate regular reports on quality assurance metrics and present findings to management and at Continuous Quality Management meetings.
• Update and maintain 477 enrollment/eligibility databases, intake forms, orientation packets, and workshop schedules as needed.
• Support eligibility and case management staff by providing recommendations to direct management regarding case actions and improvement areas.
• Participate in development and improvement of quality assurance policies and procedures to enhance efficiency and effectiveness.
• Communicate findings to relevant stakeholders through meetings, quarterly and bi-annual staff training sessions.
• Partner with other departments to identify opportunities for process improvement and program enhancement.
• Become proficient with regulations, policies, and procedures associated with financial assistance programs.
• Reviews and investigates appeals and complaints referred by the Participant Engagement Coordinator, and delivers timely feedback and decisions to ensure prompt resolution.
• Identifies and reports to the Quality Assurance and Training Manager appeals trends, and collaborates with staff to develop mitigation strategies for recurring issues and errors.
• Develops monthly and quarterly trend analysis reports for Continuous Quality Management (CQM) review.
• Perform all related duties as needed and assigned.

• Strong analytical skills with exceptional attention to detail.
• Excellent verbal and written communication skills.
• Demonstrated ability to systematically review and evaluate cases to maintain and enhance overall quality.
• Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations.
• Strong problem-solving skills with ability to compute ratios and interpret graphs.
• Demonstrated ability to coordinate multiple activities and work as an active participant in a team environment.
• Strong computer skills and group/team facilitation abilities.
• Ability to maintain positive working relationships with CITC staff and external stakeholders.
• Demonstrated knowledge and understanding of the social, health, educational, training, and cultural needs of the Alaska Native and American Indian community.
• Ability to maintain confidentiality following all applicable rules governing confidentiality, HIPAA, and CFR 42.

CITC Values, Respectful Leadership, Professionalism, Emotional Intelligence, Problem Solving/Critical Thinking, Communication Skills.

• Continued employment is contingent upon completion of satisfactory state and federal fingerprint criminal background check.
• Bachelor's degree in Business Management or related field. Relevant work experience may substitute for education requirement on a year-for-year basis.
• Two (2) years of program management and/or…