Quality Audit Specialist

Job Description

Quality Audit Specialist

The Center for Elders’ Independence is a PACE (Program of All-Inclusive Care for the Elderly) organization that uses an interdisciplinary team approach to care planning and care implementation for the purpose of providing high quality, affordable, integrated health care services to the elderly, including an A dult D ay H ealth C enter , and promoting autonomy, quality of life and the ability of individuals to live in their communities.

The Position : Under the supervision of the Director of Quality Improvement, the Quality Audit Specia list is responsible for overseeing the audit readiness and compliance efforts for Centers for Elders’ Independence (CEI). Through medical rec ord auditing this position will ensure adherence to, state, and federal PACE regulations . The Quality Specialist will be the lead in identifying trends and working with key stakeholders to develop and carry out process improvement efforts to ensure regulatory compliance.

Duties & Responsibilities :

• Medical Record Auditing : Conduct thorough audits of medical records as needed for the Quality Department to ensure adherence to state, and federal PACE regulations.
• Documentation Management : Maintain accurate and up-to-date documentation related to audits, compliance efforts, and process improvement activities. Ensure all records are organized and easily accessible for review.
• Audit Readiness : Participate in CEI’s Audit Readiness Committee. Prepare agenda and maintain minutes. Assist the committee by developing and implementing comprehensive aud it readiness strategies based on medical record and other records audits. Maintain knowledge of Federal and State PACE regulations and regulatory audit protocols.
• Trend Analysis : Identify and analyze trends in audit findings and compliance data. Develop action plans to address any recurring issues and implement preventive measures.
• Process Improvement : Collaborate with key stakeholders to develop and execute process improvement initiatives aimed at enhancing medical record compliance. Lead projects to streamline and optimize compliance processes.
• Stakeholder Engagement : Communicate effectively with internal teams and external partners to ensure clear understanding and implementation of compliance requirements.
• Collaborate with the IDT on audit findings and trends and provide ongoing education and training to ensure best practices for documentation are being followed.
• Reporting : Prepare detailed reports on audit findings, compliance status, and process improvement efforts. Present findings and recommendations t o CEI’s Audit Readiness Committee and Quality Improvement Committee
• Other Duties : Ensure licenses for all PACE facilities are up to date including but not limited to DHCS, CDPH, CERS, EPA, etc .

Q ualifications :

The above job description is intended to communicate the general function of the mentioned position and by no means shall be considered an exhaustive or complete outline of the specific tasks and functions that will be required.  CEI reserves the right to change job descriptions, site assignments, and or work hours as required by the needs of the program.  All employees are expected to perform their duties within their ability as required by the job and / or as requested by management.

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