• Full Time
  • Okemos, MI
  • Employer Type: Nonprofit

MPHI is a Michigan-based and nationally engaged, non-profit public health institute.  We are a team of teams, process and content experts, dedicated to building A world where tomorrow is healthier than today!

 

Title:                              MI Choice Quality Assurance Reviewer

                                        $35.09 – $36.53 / Posted Thru:  6-30-22

                                           

Location:                     Okemos, MI – Hybrid – Michigan Residency Required

 

Purpose:  As a licensed Registered Nurse or Social Worker case reviewer for the MI Choice Home and Community-Based Services program, you will be on-site at agencies and program participant premises to conduct record reviews, home visits, and collaborate with MDHHS staff on additional data gathering. When on-site you will promote the image of a professional reviewer and provide guidance and coaching to other team members when required.  This position can be either full-time or part-time.

 

Duties and Responsibilities:

  • Maintain Michigan licensure as a registered nurse or social worker.
  • As a member of the Clinical Quality Assurance Review (CQAR) team, complete the CQAR for each of the 20 contacted MI Choice waiver agencies, including 10-50 clinical records, and 5-20 home visits, depending on the number of MI Choice participant enrollments.
  • Provide reports to MDHHS within two weeks of completing the CQAR at the waiver agency.
  • Maintain close contact with MDHHS when reports cannot be released within two weeks of completing the CQAR.
  • Maintain close contact with other CQAR team members throughout the review process.
  • Use the MI Choice site review protocol developed by MDHHS for completing the CQAR.
  • Set up dates and times with each waiver agency for completing the CQAR.
  • Follow the protocol for reviewing records at an agency, maintaining close contact with MDHHS when invoking the protocol for reviewing additional records and/or initiating additional home visits.
  • Abide by the MI Choice program requirements, documentation expectations and requirements, the MI Choice Site Review Protocol, and all other relevant rules, regulations, standards, and policy.
  • Conduct administrative reviews according to established MDHHS protocols, if requested by MDHHS and agreed to by MPHI.
  • Promptly notify MDHHS of any concerns or issues found while completing the CQAR that may adversely affect participant health and/or welfare.
  • Always represent the best interest of MPHI.
  • Other duties as assigned.

Qualifications/Requirements:

 

Education:  Degree in Nursing, social work, or related field required.  Bachelor’s degree preferred.  RN or Social Worker with current MI license required.

 

Experience:  Minimum of 5 years’ experience in at least one of the following: home or community-based nursing, case management, or record reviews.

 

Important Skills and Characteristics:

  • Strong computer literacy in MS Office required.
  • Advanced PC and Windows software skills.
  • Excellent communication skills, verbally and written and an ability to deal with upset or frustrated clients.
  • Strong leadership skills.
  • Excellent organizational skills.
  • Ability to work independently.
  • Knowledge of alternative delivery of care for the aged, customer service and quality management.

 

Work Environment and Physical Requirements: Job may require moderate physical effort including lifting materials and equipment of <50# and involves viewing a CRT or VDT screen 25% to 75% of the time. Standard office environment at Client sites, requires a valid vehicle operator’s license where needed to perform duties of the position.

 

RESPONSIBILITY FOR THE WORK OF OTHERS:  No assigned responsibility.

 

IMPACT ON PROJECTS, SERVICES AND OPERATIONS:  The CQAR reviewer interacts on a regular basis with MDHHS staff and MPHI-IST staff, other reviewers, vendors, clients, potential clients, etc. and it is extremely important that this person present themselves in a very professional manner at all times to retain MPHI’s excellent reputation in improving public health in Michigan.

 

REQUIRED COMMUNICATION

Contact Person/Group

Frequency

Purpose

Program Manager

Daily

Meetings and Information

QA Specialist

Daily

Administrative Assignments

MDHHS Staff

Daily

Administrative Assignments

Other MPHI Staff

Daily

Meetings and Information

Clients

Daily

Record Reviews, Home Visits, Etc.

 

“For purposes of employment standards, this classification is “Non-Exempt” from overtime provisions of the fair Labor Standards Act.”

 

MPHI works with you to promote health for everyone.  Together, we will build a world where tomorrow is healthier than today!

MPHI is an EEO/AA employer that participates with e-verify.

Tagged as: Medical/Health/Counseling