OverviewUnder the direction of the Director of Quality, Disability Evaluation Services (DES) and in collaboration with other senior and executive staff, the Program Compliance Manager is responsible for assuring that disability determinations conducted within DES are compliant with state and federal regulations, and interagency agreements. In addition, this position may assist in RFP research, proposal response and in some instances, act as a funded contributor (staff assignment) in new business projects awarded.
Responsibilities- Develop criteria and methodologies consistent with program goals to evaluate the accuracy of the process and outcome of disability determinations.
- Monitors data collection, reporting and trending activities relating to program compliance activities.
- Facilitates the Quality Assurance Team with the development of quality improvement initiatives and their overall effectiveness in accordance with the DES mission and all regulatory requirements.
- On an ongoing basis, conducts random sample assessments of disability determinations, targeting general areas of improvement and the accuracy and quality of reviews conducted by disability review staff.
- On an ongoing basis collaborates with appropriate DES staff to assist in the development and presentation of training initiatives designed to improve accuracy and quality of the review process.
- Prepares reports to the agencies regarding quality assessment.
- Provides expert content material toward RFP deliverables
- Research and draft agency procedural standards in accordance with relevant State and Federal regulations
- Performs other duties as assigned/needed
QualificationsREQUIRED QUALIFICATIONS:- Bachelor's Degree or in Health related field or equivalent
- 3-5 related professional experience; experience in health-related setting
- Provide leadership in a dynamic team environment.
- Demonstrated commitment to and experience with modern technological tools and systems
- Experience with case review in the context of applying regulations
Additional InformationPreferred Qualifications:
Master's Degree in health-related field or equivalent
Regulatory experience with social security disability determination process
