Quality Assurance Specialist​/Certified Peer Support Specialist

Overview

Pikeville - 173 Redale - Pikeville, KY 41501

Salary Range: $19.50 - $19.50 Hourly

Position Type: Full Time

Education Level: High School

Position Summary: 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.

• 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 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.
• Work 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.
• Provide 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.
• Engage individuals and families in crisis planning process using evidence-based practices including Motivational Interviewing and Mental Health First Aid.
• Facilitate stabilization and care coordination services post-acute intervention.
• Provide after-hours services on a rotation schedule.

• Excellent communication skills.
• Ability to exercise good judgment and discretion.
• Ability to work well in a team environment.
• Adherence to the highest standard of ethical conduct, especially to standards governing confidentiality.
• Professional appearance and demeanor.
• Must be sensitive to populations served.
• Valid driver’s license and ability to obtain and maintain West Care’s vehicle insurance.
• During tenure with West Care new requirements, including vaccinations, may be issued; HR or appropriate personnel will inform applicants.

• Training and/or experience in Crisis Intervention is preferred.
• Two (2) years demonstrated recovery time from a significant mental health and/or substance abuse disorder at the date of application and within the last year either maintained at least 12 months of successful work or volunteer…