DCM Quality Analyst - Clearwater, FL

Endeavors; Clearwater (FL); On-site; USD 42,000 - 65,000; Full time

Job summary

Endeavors in Florida is seeking a journey-level quality assurance professional to plan, develop, and administer internal QA and compliance activities. You will ensure supervisors are in compliance and oversee case compliance to prevent policy violations.

This role requires driving quality across social service programs and supporting auditors and management. The position involves travel and weekend/holiday coverage as needed, with strong emphasis on data extraction, trend analysis, and

Qualifications

• Experience in social service financial eligibility determination, auditing, or investigating work.
• Graduation from an accredited four-year college or university with major coursework in CS/IS or related field preferred.
• Knowledge of federal and state program policies and laws.

Responsibilities

• Develops and implements quality assurance programs.
• Plans and organizes case review assignments.
• Conducts case and quality control reviews of programs.
• Verifies information from readings, sources, and clients.
• Communicates final determination of case review to staff.
• Assist with development or implementation of compliance policies across the program.

Skills

Policy knowledge

Interviewing

Data analysis

Computer skills

Education

Bachelor's degree in CS/IS or related field

Job description

JOB PURPOSE:

Performs routine (journey-level) quality assurance work. Work involves planning, developing, and administering internal quality assurance and compliance activities. Works under moderate supervision, with limited latitude for the use of initiative and independent judgment. Provides physical presence in ensuring Supervisors are in compliance. Develops and oversees case compliance to prevent or address with violations of policy and procedures.

ESSENTIAL JOB RESPONSIBILITIES:

• Develops and implements quality assurance programs.
• Plans and organizes case review assignments.
• Conducts case and quality control reviews of programs.
• Verifies information received from case readings, sources, and clients.
• Participates in corrective action planning and service improvement activities.
• Identifies cases for investigation of potential fraud and for potential recoupment and restitution.
• Reviews and analyzes cases, notes deficiencies, and extracts data to be verified; collects
• performance data; identifies adverse trends; and determines compliance with service delivery standards, program requirements, and policies and procedures.
• Documents review findings.
• Communicates final determination of case review to appropriate staff.
• May analyze quality control error findings for trends or patterns.
• Performs related work as assigned.
• Assist with the development or implementation of compliance-related policies and procedures throughout the DCM Program
• Communication, monitoring, or enforcement of all compliance standards.
• Report violations of compliance or regulatory standards.
• Provide assistance to internal or external auditors in compliance reviews.
• Discuss emerging compliance issues with management and/or employees.
• Identify compliance issues that require follow-up or investigation.
• Conduct scheduled internal reviews or audits.
• Conduct or direct the internal investigation of compliance issues.

EDUCATION:

Experience in social service financial eligibility determination, auditing, or investigating work. Graduation from an accredited four-year college or university with major coursework in computer science, computer programming, software engineering, or network administration or a related field is generally preferred.

KNOWLEDGE, SKILLS, AND ABILITIES:

Knowledge of federal and state program policies and laws, of financial and medical eligibility program policies, and of quality control procedures.

Skill in interviewing, in analyzing data, and in the use of a computer and applicable software.

Ability to apply program and quality control policies and procedures; to ensure compliance with state and federal regulations; to select, analyze, and evaluate information from case records in relation to eligibility criteria; and to communicate effectively.

EXPERIENCE:

3+ year's case management experience serving youth, individuals and families in crisis. Experience with disaster and emergency services a strong plus.

ATTENDANCE:

Must maintain regular and acceptable attendance at such level as is determined in the employer's sole discretion.

LICENSES:

Driver's License with clear record required.

VEHICLE:

Must have daily use of a vehicle without prior notice.

OTHER:

Must pass criminal and child abuse registry background checks. Must be available and willing to travel to various locations and with such frequency as the business need dictates; including deployment within 24 hours to disaster locations for as long as 2-4 weeks. Must be available and willing to work nights, weekends and holidays as required to meet business needs. Must not pose a threat or significant risk of substantial harm to the safety or health of himself/herself or others.

Endeavors has a longstanding practice of providing a work environment that is free from all forms of employment discrimination, including harassment, because of race, color, sex, gender, age, religion, national origin, marital status, sexual orientation, gender identity, genetic information, disability, military or veteran status, or any other characteristic protected by law. We recruit, hire, employ, train, promote, and compensate individuals based on job-related qualifications and abilities.

Endeavors also provides reasonable accommodation to qualified individuals with disabilities or based on a sincerely held religious belief, in accordance with applicable laws. If you need to inquire about an accommodation, or need assistance with completing the application process, please email [e-mail] or speak with your recruiter.

Endeavors is dedicated to offering reasonable accommodations for individuals with disabilities. If you are a qualified candidate with a disability and need help submitting your application online, please reach out to us at [e-mail]. If you are chosen for an interview, we will provide further details on how to request accommodations for the interview process.