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Quality Assurance Manager (Home Care)

Department: Compliance
Location: Frisco, TX

POSITION SUMMARY: Reporting to the Vice President of Quality Assurance, the Regional Quality Assurance Manager is responsible for facilitating and assuring in home care service billing is compliant with applicable Medicaid, Medicaid waiver, MCO, and other licensure and contractual requirements throughout all Addus personal care locations.This is remote position and the person will rarely be expected to travel. This position will primarily focus on billing audits.

>> We offer our team the best <<

  • Medical, Dental and Vision Benefits
  • Continued Education
  • PTO Plan
  • Retirement Planning
  • Life Insurance
  • Employee discounts
  • Company matched 401K

ESSENTIAL DUTIES:

  • Investigate and respond to requests for billing audits and recoupments from payers by reviewing records and documentation.
  • Develop, review, revise and implement standardized state specific policies, procedures and work processes that comply with Medicaid and other regulatory/contractual payer agreements
  • Educate branch leadership and staff on state regulatory and contract requirements.
  • Perform desktop audits and monitoring to assess branch level compliance with applicable rules and regulations.
  • Oversee and support external agency audit processes including audit preparation, deficiency remediation and corrective action planning.
  • Monitor corrective action execution and drive accountability.
  • Drive operational compliance and quality outcomes.
  • Report internal and external audit findings at all levels including branch, regional and senior leadership.
  • Facilitate investigation, reporting and resolution of incidents and complaints related to billing practices.
  • Performs other duties as assigned

PERFORMANCE RESPONSIBILITIES:

  • Maintain positive internal and external customer service relationships
  • Maintains open lines of communication
  • Plans and organizes work effectively and ensures its completion
  • Meets all productivity requirements
  • Demonstrates team behavior and promotes a team-oriented environment
  • Actively participates in Continuous Quality Improvement
  • Represents the organization professionally at all times

POSITION REQUIREMENTS & COMPETENCIES:

  • Bachelor’s Degree in Business, Social Services, Public Administration, or a related field of study
  • 3 – 5 years of experience in health care, social services or a related industry
  • Audit experience is strongly preferred
  • Some experience in a large, fast-paced, results-driven, multi-site organization
  • Must possess strong communication, written, interpersonal and organizational skills
  • Proficiency in using Microsoft Word, Excel, PowerPoint and Outlook, required. • Position may work remotely.
  • Must be self-confident, thorough, and prompt in completing assignments and projects
  • Passionate, energetic, tenacious and resolute, with a high sense of urgency and a strong drive to produce results

To apply via text, text 8133 to (334) 518-4376

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