Quality Assurance Coordinator (Remote - New York)

Description & Requirements

Maximus is currently hiring for a Coordinator - Quality Assurance.

This position applies the practices and procedures developed for the C-YES Quality Assurance Department to help maintain an effective quality assurance program and training to the Family Support Coordinators and other C-YES staff.

Maximus has partnered with the New York State Department of Health to establish the Children and Youth Evaluation Service (CYES) program to determine whether a child or youth is eligible for home and community-based services (HCBS) covered by Medicaid.

CYES makes eligibility determinations primarily for children and youth aged 0-21 years who have been identified as being Medically Fragile (MDF) or having a Serious Emotional Disturbance (SED).

CYES Nurse Evaluators conduct conflict-free evaluations of these children and youth to assess their needs for HCBS and develop person-centered plans of care.

CYES Family Support Coordinators provide coordination and referral services and assist HCBS-eligible children or youth to apply for Medicaid.



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*This is a full time, remote position that can be located in the state of either New York or New Jersey.

Essential Duties and Responsibilities:

- Responsible for evaluating staff members on the quality of work performed as measured against project standards, contractual requirements, and performance measures.

- Assist with the development, design, and recommend strategies or activities intended to improve performance.

- Assist with the development, analysis and distribution of project reports and performance indicators.

- Regularly assess the knowledge needs of the staff related to processes and policies regarding the client/contract operations and develop plans to meet those requirements.

- Conduct monitoring activities for quality assurance purposes.

- Assist with monitoring performance and meeting contractual requirements.

- Remain up-to-date on policies and procedures for all operations, assists in developing new procedures, and updates existing procedures when changes occur.

- Assist in the production and update of staff resource materials including quick reference guide, matrices, charts, and workflows.

- Assist with staff training, as necessary.

- Perform other duties as may be assigned by corporate management.

-Examine cases at random for completeness, accuracy and consistency

-Examine data for outliers and research such cases

-Develop / complete reports that track and trend activities / outcomes

-Quality-check consumer Notices and mailings

-Compare consumer Notices prior to mailing against information in MaxEB

-Ensure Notices contain language regarding Fair Hearings when applicable

-Ensure reports are accurate and all standards are being met

-Collect data related to assessments and assessment outcomes

-Develop and teach training modules for C-YES educational activities including Orientation and ongoing C-YES In-Services

-Provide QA training to C-YES staff in ...