QA Case Review Specialist for Program Quality

Holland America-Princess (Holland America Dawson City Inn); Anchorage, Northern (AK, KY); Hybrid; USD 55,000 - 75,000; Full time

Job summary

COOK INLET TRIBAL COUNCIL, INC. is seeking a Quality Assurance Case Review Specialist in the Financial Assistance department to ensure data integrity and service quality across programs.

You will conduct comprehensive case file reviews, analyze compliance, and support staff training to improve timeliness and accuracy of eligibility determinations and case management. In this non-exempt role, you will collaborate with cross-functional teams, generate QA metrics, and maintain thorough

Qualifications

• Bachelor's degree in Business Management or related field; relevant work experience may substitute.
• Two years of program management and/or program monitoring experience.
• Continued employment contingent upon satisfactory state and federal fingerprint background check.

Responsibilities

• Conduct comprehensive eligibility and case management quality assurance case file reviews to ensure compliance with established standards, protocols, and CARF requirements.
• Monitor data integrity and accuracy within financial assistance databases to ensure alignment with CITC, CARF, and funding performance requirements.
• Analyze case documentation to identify discrepancies, document trends, and provide recommendations for process improvement and error mitigation.
• Develop and implement training on regulations, policies, procedures, and best practices for financial assistance staff.
• Support Senior Director and Program Managers with development of monthly, quarterly, and bi-annual grant reports and performance metrics.
• Collaborate with cross-functional teams to address quality issues, implement corrective actions, and enhance overall program effectiveness.
• Maintain comprehensive documentation of quality assurance processes, findings, and improvement initiatives.
• Generate regular reports on quality assurance metrics and present findings to management and at Continuous Quality Management meetings.
• Update and maintain 477 enrollment/eligibility databases, intake forms, orientation packets, and workshop schedules as needed.
• Support eligibility and case management staff by providing recommendations to direct management regarding case actions and improvement areas.
• Participate in development and improvement of quality assurance policies and procedures to enhance efficiency and effectiveness.
• Communicate findings to relevant stakeholders through meetings, quarterly and bi-annual staff training sessions.
• Partner with other departments to identify opportunities for process improvement and program enhancement.
• Become proficient with regulations, policies, and procedures associated with financial assistance programs.
• Reviews and investigates appeals and complaints referred by the Participant Engagement Coordinator, and delivers timely feedback and decisions to ensure prompt resolution.
• Identifies and reports to the Quality Assurance and Training Manager appeals trends, and collaborates with staff to develop mitigation strategies for recurring issues and errors.
• Develops monthly and quarterly trend analysis reports for Continuous Quality Management (CQM) review.
• Perform all related duties as needed and assigned.

Skills

Analytical skills

Attention to detail

Verbal and written communication

Reading and interpreting regulations

Problem solving

Team collaboration

Confidentiality awareness

Education

Bachelor's degree in Business Management or related field

Job description

COOK INLET TRIBAL COUNCIL, INC. is seeking a Quality Assurance Case Review Specialist in the Financial Assistance department to ensure data integrity and service quality across programs.

You will conduct comprehensive case file reviews, analyze compliance, and support staff training to improve timeliness and accuracy of eligibility determinations and case management. In this non-exempt role, you will collaborate with cross-functional teams, generate QA metrics, and maintain thorough