Quality Assurance Specialist​/Certified Peer Support Specialist

Pikeville - 173 Redale - Pikeville, KY 41501 Overview Salary Range: $19.50 - $19.50 Hourly Position Type:
Full Time Education Level:
High School Description

Person in this position will be responsible for assisting the agency in ensuring that documentation requirements for Medicaid, Medicare and other funding sources per chapter and contract guidelines are adhered to. Responsibilities include but are not limited to: clinical records review, medical records, staff training compliance, and interdepartmental communication.

Person in this position is also responsible for providing peer leadership, outreach, advocacy, coaching and recovery support within the community. Essential Job Functions include:

• Possess and/or develop expertise in the areas of quality documentation and records review in relation to Medicaid/Medicare regulations and all other federal, state and local rules and regulations that apply to West Care Kentucky’s specific programs.
• Develop and/or utilize existing monitoring tools, forms, processes and implement systems for compliance in all programs which will ensure that the programs and individuals meet documentation requirements and clinical records through monitoring, education and training
• Conduct quality assurance site based reviews of client files
• Coordinate and facilitate ongoing trainings in relation to documentation fundamentals, staff onboarding, and other like trainings as assigned or. based on record review findings
• Manage and monitor West Care Kentucky’s annual training plan and conduct staff training outstanding reports and follow up adherence measures.
• Possess and/or develop expert proficiency in West Care Kentucky’s electronic health record; in the client file, service manager, and reporting features.
• Manage medical records; requests, distribution, ROIs, communication, etc.
• Attend staff meetings, training and in-service as assigned by supervisor and/or as required by the agency;
• Develop concise and timely reports, including reports by program regarding client file reviews, as necessary and distribute reports to the management team on a defined basis
• Serve as a positive role-model to individuals and their families, sharing experiential knowledge and skills.
• Works with individuals, families, and groups to provide outreach and emotional support.
• Educate and refer clients to community agencies and businesses that appropriately address their need for food, shelter, clothing, employment, transportation, social service benefits, etc.
• Provides warm hand off to community resources, services, and supports.
• Provide services that promote wellness, recovery, and resiliency.
• Assist clients with establishing or re-establishing support systems within their community.
• Engage with the family members of (or other persons significant to) those in crisis to educate them about self-care and ways to provide support
• Participate in clinical staffing decisions regarding the patients’ current strengths and resources and their need for additional resources.
• Engages individuals and families in crisis planning process using evidenced based practices including Motivational Interviewing and Mental Health First Aid.
• Facilitates stabilization and care coordination services post-acute intervention.
• Provides after hours services on a rotation schedule.
• Possess and/or develop expertise in the areas of quality documentation and records review in relation to Medicaid/Medicare regulations and all other federal, state and local rules and regulations that apply to West Care Kentucky’s specific programs.
• Develop and/or utilize existing monitoring tools, forms, processes and implement systems for compliance in all programs which will ensure that the programs and individuals meet documentation requirements and clinical records through monitoring, education and training
• Conduct quality assurance site based reviews of client files
• Coordinate and facilitate ongoing trainings in relation to documentation fundamentals, staff onboarding, and other like trainings as assigned or. based on record review findings
• Manage and monitor West Care Kentucky’s annual training plan and conduct staff training…