Quality Review Specialist III

Qlarant is a not-for-profit corporation that partners with public and private sectors to create high quality, safe, and efficient delivery of health care and human services programs. We have multiple lines of business including population health, utilization review, managed care organization quality review, and quality assurance for programs serving individuals with developmental disabilities. Qlarant is also a national leader in fighting fraud, waste and abuse for large organizations across the country. In addition, our Foundation provides grant opportunities to those with programs for underserved communities.

Best People, Best Solutions, Best Results

Job Summary:

Facilitates routine evaluations to assess the extent to which individuals with intellectual developmental disabilities (IDD) are receiving customized support and services tailored to their unique needs and specific situations. Performs scheduled reviews to assess how effectively IDD service providers are in preserving the health and safety of the individuals in their care. Assists management in identifying areas for improvement in service delivery, providing technical assistance, generating meaningful recommendations, and collaborating with service providers to execute continuous improvements that meet the needs of individuals with developmental disabilities.

Essential Functions:

• Administers detailed evaluations of programs and service providers to assess their effectiveness and adherence to established standards. 
• Ensures that programs comply with relevant laws, regulations, and policies related to developmental disabilities. 
• Determines areas for improvement in programs and services and works with stakeholders to implement quality enhancement initiatives. 
• Inspects documentation, reports, and records to providers to ensure that their needs are met in a respectful and prudent manner. 
• Advocates for the rights and well-being of individuals with developmental disabilities and ensures that their needs are met in a respectful and person-centered manner. 
• Analyzes data related to program outcomes, client satisfaction, and other relevant metrics to inform decision-making and continuous improvement efforts. 
• Communicates with service providers, agencies, and stakeholders involved in providing services to individuals with developmental disabilities.
• Develops and provides technical assistance, training and guidance to staff and service providers on best practices, quality standards, and compliance requirements. 
• Exercises professional judgment and takes immediate action in the case of abuse, neglect, and/or exploitation by following established protocols. 
• Conducts interviews with individuals receiving services and provider staff in a respectful manner. 
• Documents accurate review findings and generates reports based on the results.

Level of Supervision Received:
Plans and arranges own work; works with manager to prioritize projects

Education (can be substituted for experience):
Minimum Bachelor's Degree required

Work Experience (can be substituted for education):
5 - 7 years of experience required; 8 - 11 years preferred

Certification(s):
Must meet the criteria to be a Developmental Disabilities Professional (DDP) and Qualified Intellectual Disabilities Professional (QIDP)

Qlarant is an Equal Opportunity Employer of Minorities, Females, Protected Veterans, and Individuals with Disabilities.

Qlarant is a drug-free workplace. All offers of employment are contingent upon successful completion of pre-employment background and drug screens.