Provider Quality & Compliance Specialist

Lakeland Care, Inc.; Fond du Lac (WI); Presencial; USD 65 000 - 85 000; Tempo integral

Resumo da oferta

Lakeland Care, Inc. is seeking a Provider Quality Specialist to support a network of high-quality service providers for our Family Care members in Wisconsin. You will monitor provider quality, assist in remediation, and strengthen provider contracts and community resources.

You will collaborate with the Provider Quality Supervisor and other stakeholders to drive quality improvements, conduct on-site visits, educate providers on Family Care statutes, and promote best practices across the network.

Qualificações

• Bachelor’s degree in a human service or business-related field, or equivalent combination of formal education and experience required.
• Minimum of three (3) years of experience working with the population(s) served in the Family Care program and/or service provider industry.
• Strong knowledge of the service provider industry, including licensing requirements and regulations.
• Must demonstrate proficiency in Microsoft Office (Word, Excel, PowerPoint, Outlook).
• Must have exceptional verbal and written communication skills.
• Effective communication skills, strong organizational skills, and meticulous attention to detail.
• Strong critical thinking and analytic skills.
• Ability to develop strong working relationships and disseminate information appropriately.
• Current driver’s license, acceptable driving record and proof of adequate insurance required.

Responsabilidades

• Collaborate in developing quality standard definitions for providers and consistent processes to evaluate the quality of services rendered to members.
• Maintain a thorough understanding of regulations relating to licensure in residential and skilled nursing facilities, as well as member rights and serve as a resource to providers to improve the quality-of-service delivery.
• Review quality data monthly to identify trends of quality concerns per established thresholds and make recommendations for action plans with providers towards quality improvement.
• Make recommendations to contracted providers’ policies and procedures, collaborate with providers regarding Statements of Deficiency from regulatory agencies, conduct on-site provider visits as required, actively engage in provider oversight process, and make best practice recommendations to assist in enhancing the provision of provider quality.
• Promote quality work of the providers and is a strong leader in identifying and facilitating provider quality oversight.
• Communicate effectively with LCI contracted providers as well as other LCI departments to support and enhance organizational practices.
• Respect other opinions and concerns and value diversity in thought and action.
• Provide education to contracted providers regarding the Family Care program and state statutes.
• Collaborate with providers in LCI incident review, related policy/procedure review, risk remediation and best practices.

Conhecimentos

Verbal communication

Written communication

Analytical skills

Organizational skills

Driver's license

Formação académica

Bachelor's degree in human services or business-related field

Ferramentas

Microsoft Office

Descrição da oferta de emprego

Lakeland Care, Inc. is seeking a Provider Quality Specialist to support a network of high-quality service providers for our Family Care members in Wisconsin. You will monitor provider quality, assist in remediation, and strengthen provider contracts and community resources.

You will collaborate with the Provider Quality Supervisor and other stakeholders to drive quality improvements, conduct on-site visits, educate providers on Family Care statutes, and promote best practices across the network.