Overview

Job DescriptionJob DescriptionThe Quality Assurance Specialist is responsible for ensuring compliance, accuracy, quality improvement, and regulatory adherence across Financial Management Services (FMS) programs. This position supports the organization's commitment to delivering high-quality services by conducting audits, monitoring program operations, analyzing trends, investigating compliance concerns, and identifying opportunities for process improvement.Key Responsibilities:Quality Assurance Reviews and Audits Maintains current knowledge of federal, state, payer, and organizational requirements governing Financial Management Services programs.Conducts routine and targeted audits of participant, attendant, payroll, enrollment, compliance, and administrative records to ensure accuracy, completeness, timeliness, and regulatory compliance.Identifies deficiencies and works collaboratively with program staff to implement corrective actions.Compliance MonitoringMonitors program activities to ensure adherence to agency policies, contractual obligations, program standards, HIPAA requirements, and regulatory guidelines.Conducts record reviews, interviews, and validation activities to verify that procedures are being followed consistently and effectively.Quality Review of Reports and CorrespondenceReviews outgoing reports, corrective action plans, grievance responses, critical incident reports, fraud investigations, and other communications before submission to external stakeholders.Ensures documentation is accurate, complete, professionally written, and compliant with program requirements.Data Systems AuditingPerforms audits of electronic systems and databases, including CellTrak, Netsmart, Sendata, payroll systems, document management systems, and other technology platforms.Reviews data accuracy, timeliness of documentation, and compliance with established procedures.Identifies system-related issues and collaborates with operational and information technology staff to resolve discrepancies.Documentation and ReportingMaintains detailed records of audits, investigations, corrective actions, quality reviews, and compliance monitoring activities.Produces clear, accurate, and timely documentation in accordance with departmental standards and regulatory requirements.Other DutiesPerforms additional quality assurance, compliance, and operational support activities as assigned by the FMS Quality Assurance Manager.Skills & Requirements:Bachelor's Degree in a behavioral science, human services or business administration, healthcare administration, public administration, nursing, or a related field preferred.Minimum of two (2) years of experience in quality assurance, compliance, auditing, healthcare administration, human services, case management, program monitoring, or a related field.Experience with HIPAA compliance, fraud prevention, quality improvement initiatives, or regulatory audits.Proficiency with Microsoft Word, Excel, SharePoint, PowerPoint, OneDrive, Outlook, and Teams.Experience with electronic medical records, participant databases, payroll systems, and document management systems.Strong analytical and critical-thinking skills.Excellent written, verbal, presentation, and interpersonal communication skills. What we offer: 401(k)Tuition AssistanceHealth & DentalPaid Vacation/Sick Time10-12 Holidays per yearReimbursement of mileage and travel expensesExcellent supportive business and information tools The base pay for this position ranges from $47,500 to $57,500 and will vary based on factors such as skills and experience. Base pay is one part of the Total Compensation that JEVS Human Services provides to recognize employees for their work. JEVS provides competitive Benefits; we believe that benefits should support you at work and at home. Please visit the benefits page of our careers site for more details. At JEVS, we are committed to ensuring all our employees feel included, valued, appreciated and free to be who they are at work.