OLTL Program Coordinator (Medicaid Waivers/ Quality Improvement)

Duration: Long-term

Job Summary:

• Lead the Incident Management Mortality Review/Quality Management Team within the Critical Incident Management Unit
• Oversee quality assurance, mortality reviews, and participant health, safety, and welfare initiatives for Home and Community-Based Services (HCBS)
• Ensure compliance with quality management standards, agency policies, and regulatory requirements
• Supervise quality management staff and support continuous process improvement
• Align unit activities with Money Follows the Person (MFP) initiatives to support grant sustainability

Minimum Qualifications:

• Master's degree in Social Work or a related Human Services field
• Minimum 5 years of quality improvement experience in a formal, multifaceted quality management program
• Minimum 3 years of supervisory or management experience
• Strong computer skills, including:
• • Microsoft Word and other Office applications
  • Database utilization, maintenance, and management

Role Responsibilities:

• Oversee all activities related to the Incident Management Mortality Review/Quality Management Team
• Supervise a team consisting of:
• • Risk Management Specialists
  • Review and Evaluation Nurses (Registered Nurses)
• Ensure effective incident management quality assurance activities
• Coordinate mortality reviews for HCBS participants
• Promote participant health, safety, and welfare protections
• Ensure compliance with Home and Community-Based Services (HCBS) program requirements
• Monitor alignment of unit activities with Money Follows the Person (MFP) initiatives

Key Responsibilities:

• Develop expertise in the Enterprise Incident Management (EIM) system and incident reporting processes
• Monitor and manage mortality review and quality management activities
• Analyze Quality Management Program reports and recommend corrective actions
• Conduct quality management reviews, audits, and quality assurance activities
• Supervise staff performing audits and quality reviews
• Provide leadership and training to clinical and non-clinical staff on:
• • Quality Management
  • Audit methodologies
  • Corrective action plans
• Collaborate with physicians, nurses, and internal stakeholders to support quality initiatives
• Coordinate and deliver training for:
• • Protective Service Agencies
  • Managed Care Organizations (MCOs)
  • Service Coordination Entities (SCEs)
  • Provider staff
• Oversee staff participation in IT system requirements, design sessions, and user acceptance testing
• Assist with grant sustainability reporting related to Money Follows the Person (MFP) initiatives
• Maintain professional knowledge through meetings, training sessions, seminars, and industry literature
• Participate in committees and meetings as assigned
• Perform additional duties assigned by management

Essential Functions:

• Knowledge of medical terminology and medical conditions
• Understanding of physical disabilities and limitations related to:
• • Activities of Daily Living (ADLs)
  • Instrumental Activities of Daily Living (IADLs)
• Knowledge of OLTL Medicaid Waivers, Act 150, regulations, policies, and procedures
• Ability to develop reports supporting grant sustainability and funding continuation
• Comfortable working remotely using videoconferencing and telephone platforms
• Ability to work independently with minimal supervision
• Strong presentation and public speaking skills
• Excellent organizational and prioritization abilities
• Advanced critical thinking and problem-solving skills
• Strong verbal and written communication skills
• Ability to interpret local, state, and federal laws and regulations
• Ability to educate, mentor, and train subordinate staff
• Ability to travel independently, including overnight travel without public transportation

Required Skills:

• Quality Management and Quality Assurance
• Incident Management
• Mortality Review Processes
• Root Cause Analysis
• Audit Management
• Staff Supervision and Leadership
• Training and Development
• Report Writing and Data Analysis
• Regulatory Compliance
• Program Evaluation
• Cross-functional Collaboration
• Microsoft Office Suite
• Database Management
• Enterprise Incident Management (EIM) System
• Home and Community Services Information System (HCSIS)
• WellSky
• Client Information System (CIS/e-CIS)

Soft Skills:

• Strong leadership and team management
• Excellent analytical and critical thinking skills
• High attention to detail
• Strong organizational and time management abilities
• Self-motivated and able to work independently
• Effective interpersonal and communication skills
• Ability to manage multiple priorities
• Adaptability and continuous learning mindset
• Professional judgment and decision-making
• Commitment to quality, participant safety, and regulatory compliance