Quality Service Reviewer

• Location: Charlottesville, VA
• Type: Contract
• Job #35036
• Salary: $35.00
• Hybrid

**Must have reliable transportation and the ability to travel to individual residences, provider offices, and service sites throughout Charlottesville/Central Virginia area.**

Quality Service Reviewers work under the direction of the client’s project leadership and are responsible for completing Quality Service Reviews (QSRs) in accordance with project timelines and deliverables. This role includes conducting individual service plan (ISP) reviews, interviews, record reviews, and observations for individuals with intellectual and/or developmental disabilities.

_{Essential Responsibilities}

• _{Complete QSR training and maintain a minimum 95% interrater reliability confidence level in applying QSR processes and documenting results in electronic tools.}
• _{Conduct virtual and onsite individual service plan reviews in accordance with applicable federal and state requirements.}
• _{Perform chart and record reviews at service delivery sites, including residential settings.}
• _{Conduct face-to-face interviews related to ISP implementation with individuals receiving services, family members or guardians, support coordinators, service providers and supervisory staff, direct care workers, and other identified stakeholders.}
• _{Observe individuals receiving services specified in their ISP.}
• _{Review findings from provider licensure surveys, complaint investigations, and compliance reviews conducted by the Medicaid agency and other oversight entities as required for QSR reporting.}
• _{Use professional judgment to identify and assess observed risks to individual health and safety.}
• _{Complete all required documentation for reviews, interviews, and observations in accordance with project standards.}

_{Qualifications (Required)}

• _{Bachelor’s, Master’s, or Doctoral degree in a human services related field.}
• _{Minimum of three years of experience in a human services related field such as long-term services and supports or developmental disabilities.}
• _{Minimum of three years of experience with developmental and/or intellectual disabilities waiver populations.}
• _{Experience conducting chart reviews, audits, interviews, focus groups, and observation activities.}
• _{Experience or understanding of Medicaid program requirements, public health, state licensure or accrediting agencies, developmental disability services, and waiver regulations.}
• _{Experience, participation, and knowledge of quality improvement and/or risk management practices.}
• _{Knowledge of healthcare confidentiality requirements (e.g., HIPAA).}
• _{Ability to communicate professionally and effectively, both verbally and in writing.}
• _{Familiarity with and ability to navigate the Virginia Waiver Management System (WaMS).}

_{Preferred Qualifications}

• _{Background as a social worker, support coordinator, behavioral health professional or technician, LPN, or RN.}
• _{Certification or experience in healthcare quality, compliance, or compliance auditing.}
• _{Proficiency in Microsoft Word, Excel, and PowerPoint.}
• _{Strong organizational, time-management, and customer service skills.}

_{Work Requirements}

• _{This is a full-time position.}
• _{Availability between 8:00 a.m. and 8:00 p.m. for scheduled onsite reviews, interviews, and observations.}
• _{Ability to sit for prolonged periods and conduct field-based work as required.}