Job Information
KEPRO Quality Review Specialist (Hybrid within the State of West Virginia) in Charleston, West Virginia
CNSI and Kepro are now Acentra Health! Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact.
Lead the Way is our rallying cry at Acentra Health. Think of it as an open invitation to embrace the company’s mission, actively engage in problem-solving, and take ownership of your work daily. Acentra Health offers you unparalleled opportunities. In fact, you have all you need to take charge of your career and accelerate better outcomes – making this a great time to join our team of passionate individuals dedicated to being a vital partner for health solutions in the public sector.
Job Summary
Quality Review Specialist plays a crucial role in provider interaction, quality measure implementation, and reporting. This role involves conducting onsite reviews and engaging with members to ensure compliance with WV I/DD Waiver health and safety standards. Responsibilities include offering general policy guidance, aggregating comprehensive review findings into overall reports, facilitating or developing training sessions, and identifying data trends to develop effective solutions. This position reports to the Clinical Assessor Supervisor and is integral to maintaining high standards of care and operational excellence.
Job Responsibilities:
Collaborate with the Supervisor to ensure the ISS/GH Assessor Team achieves contract deliverables.
Conduct onsite, health and safety reviews for I/DD Waiver members in Intensively Supportive Settings/Group Homes, while maintaining a small caseload.
Travel within West Virginia required; position is remote and in the field-based hybrid role.
Identify, assess, and assist with staff training related to their functions within the I/DD Waiver and associated departments.
Develop, refine, and report quality measures in collaboration with the Supervisor.
Develop and maintain operational guidelines and provider review tools.
Coordinate the incorporation of review findings into general provider review reports.
Coordinate and conduct training sessions as needed with providers and stakeholders.
Aggregate data from review findings, the Incident Management System, and other sources.
Work with the Supervisor to analyze data and develop guidance based on findings.
Engage in ongoing planning, development, and maintenance of an internal monitoring program for review activities performed by the clinical review team.
Assess potential problems and recommend corrective actions to resolve or mitigate associated risks.
Prepare and submit reports and deliverables in a timely manner as required.
Undertake and complete special projects as assigned.
The list of accountabilities is not intended to be all-inclusive and may be expanded to include other duties that management may deem necessary.
Required Qualifications/Experience:
Bachelor’s degree or equivalent required.
Applicable experience in quality improvement, including performing quality audits, evaluating processes, and developing improvement measures, is preferred.
Must be a WV resident and have a minimum 2 to 3 years’ experience in the West Virginia I/DD Waiver program.
Proficient in Microsoft software with the ability to leverage its tools effectively.
Ability to build and maintain effective working relationships.
Strong skills in preparing and presenting findings, offering support and guidance clearly.
Excellent verbal and written communication skills for smooth interaction with team members and stakeholders.
Delivers excellent customer service and maintains professionalism in challenging discussions.
Experience with West Virginia State reporting systems and a strong understanding of I/DD Waiver policy.
Strong commitment to problem-solving and close attention to detail in complex situations.
Strives for excellence and actively seeks ways to improve job performance.
Adapts well to changes and maintains an open-minded attitude.
Positively contributes to a collaborative work environment by working well with others.
Ability to stay organized and efficient while handling multiple tasks simultaneously.
Why us
We are a team of experienced and caring leaders, clinicians, pioneering technologists, and industry professionals who come together to redefine expectations for the healthcare industry. State and federal healthcare agencies, providers, and employers turn to us as their vital partner to ensure better healthcare and improve health outcomes.
We do this through our people
You will have meaningful work that genuinely improves people's lives nationwide. Our company cares about our employees, giving you the tools and encouragement, you need to achieve the finest work of your career.
Thank You!
We know your time is valuable and we thank you for applying for this position. Due to the high volume of applicants, only those who are chosen to advance in our interview process will be contacted. We sincerely appreciate your interest in Acentra Health and invite you to apply to future openings that may be of interest. Best of luck in your search!
The Acentra Health Talent Acquisition Team
EOE AA M/F/Vet/Disability
Acentra Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran or any other status protected by applicable Federal, State or Local law.
Benefits
Benefits are a key component of your rewards package. Our benefits are designed to provide you with additional protection, security, and support for both your career and your life away from work. Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts, and more.
Compensation
The compensation for this role is $53,00.00 - $56,000.00 base salary
Based on our compensation program, an applicant’s position placement in the pay range will depend on various considerations, such as years of applicable experience and skill level.
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