Quality & Risk Management Auditor (CAT)
Full Time
Remote
Posted
Job description
Quality & Risk Management Auditor
Company: Catalight
Department: Quality Assurance, Office of Risk Management
Reports to: SVP, Quality & Internal Audit
Status & FLSA Class: Full-Time, Exempt
Date: January 2023
Location: Remote
Catalight is the parent organization leading a family of companies (FOC) that includes Easterseals Northern California, Easterseals Hawaii, Catalight Care Services, and Xolv Technology Solutions. Across the five non-profit companies, there are nearly 700 employees working together to responsibly disrupt and transform home and community-based care and help become a diverse, equitable and inclusive organization that works proactively to address complex societal problems such as healthcare access and greater well-being for underrepresented communities.
Job Summary
The Quality Assurance Auditor conducts detailed audits and completes performance improvement plans for any deficiencies identified in audit results.
This position is part of the Quality Department within the Office of Risk Management. The Office of Risk Management (“ORM”) is collectively responsible for the day-to-day operations, planning and activities of the risk programs. ORM oversees all on-going activities related to the development, implementation, adherence and monitoring of the FoC’s Risk Management Program, and, to ensure all employees, contractors, vendors, volunteers, board members etc., conforms to the strictest standards of Compliance. ORM works closely with Leadership to implement internal controls and plans of correction when appropriate. In addition, ORM develops and implements policies and procedures as required pursuant to applicable local, state and federal rules and laws.
Core Responsibilities & Essential Job Functions
- Perform full audit cycle of current and prospective network providers.
- Develop and update audit tools.
- Develop corrective and preventative action plans for each provider based on their audit results and areas of deficiencies.
- Obtain and analyze audit results, and report on trends.
- Act as an objective source of independent advice to ensure validity, legality and goal achievement.
- Conduct follow up audits to monitor performance improvement plans towards compliance with regulations and directives.
- Develop and maintain policies, procedures, plans, schedules, and job aids for audit processes and systems.
- Works with management in the development and ongoing oversight of best practice standards.
- Participates in the training of staff and network providers regarding the directives and regulations.
- Maintains current knowledge of relevant federal and state laws such as the False Claims Act, Stark Law and Anti-kickback Statute, and accreditation standards, including those of the Commission on the Accreditation of Rehabilitation Facilities (CARF).
Qualifications
Minimum Education, Experience & Training Equivalent to:
- High School Diploma/GED required; Bachelor's degree preferred.
- 4+ years’ related experience.
- Work experience conducting audits and evaluating compliance preferred.
- Experience in health care, legislative and/or legal compliance preferred.
Knowledge & Skills:
- Sensitivity to working with an ethnically, linguistically, culturally, and economically diverse population.
- A commitment to the values of the organization while demonstrating good judgment, flexibility, patience
and discretion when dealing with confidential and sensitive matters. - Proficient in Microsoft Office (Outlook, Word, Excel, etc.), especially Excel and related computer software.
- Consistently demonstrate good judgment and decision-making skills while maintaining the highest level of confidentiality.
- Work in an exciting, fast paced high energy environment while effectively multitasking and managing day-to-day responsibilities without supervision.
- Personable; able to work comfortably with individuals at all levels within the organization.
- Excellent verbal and writing communication skills; frequent proofreading and checking documents for accuracy.
- Must be highly detail-oriented.
- Strong interpersonal skills.
Physical Requirements:
- Must be able to communicate effectively within the work environment, read and write using the primary language with the workplace.
- Visual and auditory ability to work with clients, staff and others in the workplace continuously.
- Frequent speaking and listening (25-75%) to clients, staff, and others in the workplace.
- Utilize computer and cell phone for effective communication.
Conditions of Employment
- Ability to obtain and maintain criminal record clearance through the Department of Justice (DOJ). The People & Performance Department must analyze DOJ/FBI live scan reports in accordance with applicable Federal, State, and Local laws, as well as fitness for the position.
- Ability to obtain and maintain clearance through the Office of Inspector General.
- Must attend any required training.
- COVID-19 vaccination and subsequent boosters required for any in office presence at all company locations.
About Us
At Catalight, we embrace people’s differences — both visible and invisible. And we believe everyone deserves to be understood, respected and celebrated for their many contributions. That’s why we have a bold vision to break down barriers and biases to create a more equitable world, so people with developmental disabilities and special needs can choose their own paths.
We do this by providing access to innovative, individualized care services, clinical research and advocacy — all powered by intelligent Xolv Technology Solutions. And, through the work of our affiliate partners, Easterseals Northern California and Easterseals Hawaii, we provide services to people with disabilities and their families to support them across their care journey.
Our purpose-driven teams are creating a pathway to a more impactful future. Empowering others and fostering an inclusive environment that embodies our core values to ensure we grow responsibly.
The statements contained in this job description reflect general details as necessary to describe the principal functions of this job. It should not be considered an all-inclusive listing of work requirements. Individuals may perform other duties as assigned, including work in other functional areas as deemed fit for the organization.
Catalight is an equal opportunity employer.
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