Georgia Department of Community Health

State Program Enforcement and Quality Assurance Manager, PCH Programs (00081410) - Atlanta

Atlanta, GA

Job Description

State Program Enforcement and Quality Assurance Manager, PCH Programs (00081410)

Posted: Tuesday, 4/30/2024


Pay Grade: M

The Georgia Department of Community Health (DCH) is one of Georgia's four health agencies serving the state's growing population of over 10 million people. DCH serves as the lead agency for Medicaid, oversees the State Health Benefit Plan (SHBP) and Healthcare Facility Regulation, impacting one in four Georgians.

Through effective planning, purchasing and oversight, DCH provides access to affordable, quality health care to millions of Georgians, including some of the state's most vulnerable and under-served populations. Six enterprise offices support the work of the agency’s three program divisions. DCH employees are based in Atlanta, Cordele and across the state.

DCH is committed to providing superior C*ustomer Service and Communication, embracing Teamwork and fostering A*ccountability to ensure that our internal and external customers and stakeholders feel included, respected, engaged and secure.

DCH is currently seeking qualified candidates for the position of State Program Enforcement and Quality Assurance Manager, PCH Programs with the Healthcare Facility Regulation Division. This position must be able to work hours other than just from 8:00 AM to 5 PM during the work week to meet the needs of the business as necessary and with the approval of your supervisor. This position must have the ability to travel occasionally (i.e., quarterly) for activities such as out-of-town meetings, conferences, or training sessions.

Job Responsibilities

Under general and limited supervision, the State Program Enforcement and Quality Assurance Manager will be responsible for day-to-day quality reviews related to the Personal Care Home Program surveys and training. This position may plan, organize, or coordinate the activities for processing surveys with Compliance Specialists. This position reviews, monitors, and ensures compliance with assigned program area's policies and procedures.

  • Responsible for reviewing survey reports and 670 hours, supporting documents, and Statement of Deficiencies.
  • Responsible for quality review of the plan of corrections submitted by personal care homes, assisted living centers, and adult day health programs.
  • Responsible for tracking and ensuring all processes are complete and all deadlines are met for all opportunities to correct surveys.
  • Works with the Regional Directors and Compliance Specialists team to ensure backup coverage is provided for each region.
  • Serves as the PCH subject matter expert during scheduled weekly SEC meetings.
  • Track and report survey status updates for reporting during weekly SEC meetings. Performs quality review work and program management as needed with a primary role of conducting quality assurance reviews of survey work and other job duties as assigned by the PCH Director.
  • Correspond and effectively collaborate with the PCH Director, Director of Training & QA, Regional Directors, and the Legal Team regarding an opportunity to correct surveys in assigned regions.
  • Assists program director with developing SOPs, and using the standard program writing guide while ensuring consistency and efficient documentation across the board.
  • Assist with the surveyor and RD development as requested, including orientation, in-service training, workshops, and continuing education for PCH staff.
  • Oversees the scheduling process, compiling and reporting the program's data metrics monthly, quarterly, and annually.
  • Serves as a direct backup and point of contact for the PCH Director as needed and in their absence.

Minimum Qualifications

Master's degree in a related field from an accredited college or university AND One year of management experience in the area of assignment OR Bachelor's degree in a related field from an accredited college or university AND Two years of management experience in the area of assignment OR Six years of experience in the area of assignment, Three years of which in a management role OR One year of experience required at the lower level Mgr, Regulatory Compliance (RCM050) or position equivalent.
Note: Possession of a valid Georgia driver's license, which would enable the employee to drive in Georgia, and use of a car at work, are required for employees for this job.

  • Certification(s) and/or Degree in one or more of the related fields
  • Registered Nurse
  • Experience in utilization review and/or quality assurance of a PCH/healthcare setting.
  • Experience conducting assessments and evaluations based on regulations, legal requirements, and/or recognized accreditation standards in a PCH/healthcare setting.
  • Demonstrated ability to produce high-quality documentation with attention to detail.
  • Strong communication, organizational, report-writing, and time-management skills.
  • 401(k)
  • 401(k) matching
  • Dental insurance
  • Flexible schedule
  • Health insurance
  • Paid time off
  • Professional development assistance
  • Vision insurance

Georgia Department of Community Health At A Glance

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