QUALITY ASSURANCE SPECIALIST 3

State-of-Nevad; Carson City (NV); On-site; USD 75,000 - 95,000; Full time

Job summary

Division of Child and Family Services in Nevada seeks a Quality Assurance Specialist III to review quality and effectiveness of care across juvenile justice and residential programs. You will evaluate incidents, conduct root cause analyses, and ensure compliance through statewide audits, using analytical software for data reporting.

Responsibilities include literature reviews, data visualizations, presenting findings, updating QA processes, and collaborating with partners to improve performance,

Qualifications

• Bachelor’s degree in nursing, social work, human development, special education, health science, public health, or other behavioral or social science and four years of professional experience performing program evaluation, quality assurance/improvement, and/or utilization review activities.
• OR two years of experience as a Quality Assurance Specialist II in Nevada State service.
• Review and evaluate appropriateness of client services, monitor high risk areas, and ensure compliance with regulations.

Responsibilities

• Evaluate critical incidents and identify service gaps; perform root cause analyses.
• Conduct statewide audits and evaluate quality, appropriateness of care.
• Develop and implement a comprehensive quality assurance program across settings.
• Provide training on regulations, accreditation standards, and policy requirements.
• Prepare narrative/statistical reports and support program evaluation efforts.
• Collaborate with staff and administrators to resolve deficiencies and improve outcomes.

Skills

Quality assurance

Utilization review

Regulatory compliance

Data analysis

Auditing

Education

Bachelor’s degree in nursing / social work / health sciences

Tools

Analytical software

Job description

The Division of Child and Family Services is recruiting for a Quality Assurance Specialist 3 in Carson City or Las Vegas. This position reviews the quality, appropriateness, and effectiveness of care provided through DCFS juvenile justice and out-of-state residential treatment programs. Key duties include evaluating critical incidents, identifying service gaps, conducting root cause analyses, and ensuring compliance with state and federal regulations through statewide audits. The role uses analytical software to manage and analyze data, prepare reports, and support program evaluation. Additional responsibilities include literature reviews, developing data visualizations, presenting findings, updating quality assurance processes, and collaborating with partners to improve program performance. The position also involves out-of-state travel to evaluate residential treatment facilities for Nevada youth. Applicants must be authorized to work in the U.S., as visa sponsorship is not available.

Quality Assurance Specialists design and implement a comprehensive quality assurance program encompassing clinical and related disciplines at a mental health hospital, residential care facility or community-based program or service for individuals with intellectual disabilities who may also have significant physical and/or mental health issues, rehabilitation facility, or a clinic which provides outpatient medical and psychological services, or the medical system for the Department of Corrections. Incumbents objectively and systematically review and evaluate the quality and appropriateness of client care and services, identify opportunities for improvement, and work with administrators and staff to resolve identified problems and deficiencies.

Bachelor's degree from an accredited college or university in nursing, social work, human development, special education, health science, public health, or other behavioral or social science and four years of professional experience performing program evaluation, quality assurance/improvement, and/or utilization review activities for a human services program or agency; OR two years of experience as a Quality Assurance Specialist II in Nevada State service; OR an equivalent combination of education and experience, above the Bachelor's degree level, as described above. Review and evaluate appropriateness of client services including access, outcomes and prevention; conduct case reviews including customer interviews and surveys, medical/clinical and case records, facility inspections, and agency/facility policies and procedures; assist in identification of problem areas; monitor high risk/impact areas and processes vulnerable to litigation, adverse publicity, or involvement of law enforcement.

Evaluate compliance with applicable accreditation, licensing, health and safety, and funding requirements; develop recommendations for corrective actions including serving on committees, providing written reports and summaries, and presenting findings to administrators and department staff; review citations and plans of correction from federal, State, and accreditation reviews; participate in developing corrections and monitor corrections for compliance.

Provide technical guidance to agency staff and/or contractors regarding quality assurance/improvement activities and requirements; ensure agency/facility staff, contractors and administration are aware of accreditation, licensing, funding, and human rights requirements; provide training to staff, providers, and outside agencies regarding federal and State regulations, program requirements, policies and procedures, accreditation standards, client rights, consent and confidentiality issues, due process, documentation and communication related topics, and other areas as required.

Review reports of incident, abuse and neglect, rights violations, sentinel events, serious incident, treatment appeals and complaints; ensure applicable regulations and reporting requirements are followed; conduct investigations and contact outside enforcement agencies as appropriate; ensure client confidentiality and privacy as well as the security of documents, reports, and findings.

Coordinate agency efforts to achieve and maintain accreditation; develop quality assurance/improvement criteria and methodology; coordinate self-assessments using accreditation standards; research, develop and collate data for pre-survey information packets; coordinate, write, and organize information incorporated into official corrective action plans submitted by the agency in response to survey or statements of deficiencies and findings.

Prepare narrative and statistical reports; participate in budget preparation; monitor and control expenditure of funds for staffing, equipment, supplies and other areas as required.

Perform related duties as assigned.

Under general direction, incumbents design, implement, and oversee a comprehensive quality assurance program encompassing community-based programs and inpatient services at a mental health hospital or residential facility for individuals with intellectual disabilities who may have significant physical and/or mental health issues; interpret federal and State regulations regarding licensure, certification, health and safety; lead and participate in evaluation of facility, program and/or agency policies, procedures and practices in relation to internal and external rules, regulations, and accreditation standards; identify problems relating to treatment methodology, standards of care, and client services; conduct and serve on committees to formulate solutions to service delivery problems and medical records maintenance; conduct special investigations related to the delivery of health services and prepare reports as requested; serve as liaison to accrediting and regulatory agencies to achieve and maintain facilities licensure/accreditation; supervise professional, technical, and clerical staff as assigned.

This job specification lists the major knowledge, skills and abilities of the job and is not all inclusive. Incumbent(s) will be expected to have knowledge, skills and abilities from a previous level.

Working knowledge of: quality assurance and/or utilization review audit and compliance activities including application of community and regulatory standards; application of the nursing process including assessment, diagnosis, planning, intervention and evaluation as applied to quality assurance and utilization review activities; uses, effects, side effects and interactions of commonly prescribed medications for physical ailments and psychological problems; laboratory tests and diagnostic procedures; typical courses of a variety of illnesses, injuries and conditions; physical restraint techniques and procedures appropriate to specific situations in a correctional setting; agency policies and procedures related to healthcare services and standards; principles and practices of supervision and training.

Ability to: read and interpret court orders and decisions related to inmate health care; assist the Quality Improvement Committee in internal investigations related to quality of care issues; monitor the care of inmates hospitalized outside the correctional system; supervise and evaluate the performance of assigned personnel; solicit cooperation of staff in identifying needed changes and formulating solutions; prepare each hospital service area for audits; train, supervise and evaluate the performance of assigned personnel.