Preferred Quals:

Minimum RN licensure in Georgia Mandatory

3-5 Years experience in a supervisor position

Medicare/Medicaid commercial insurance or other evidence of quality assurance auditing

Comments:

40% travel, some overnight

Hybrid position, mandatory office days

Notes:

Job Summary:

Supervises, guides, and/or instructs the work assignments of subordinate staff. May plan,

organize or coordinate the activities of an assigned program. Reviews, monitors and ensures

compliance with assigned program areas policies and procedures.

Primary Duties & Responsibilities:

· Supervises and plans work of assigned staff

· Conducts on-site reviews, audits or surveys of clinical and treatment facilities, regulated entity operations and program management

· Conducts utilization reviews, peer reviews, evaluation activities and all other reviews on a

scheduled basis

· Coordinates investigations involving noncompliance in facilities, community programs,

regulated entity operations and other related programs

· Coordinates the data management and quality assurance functions

· Determines compliance with applicable state and/or federal rules and regulations

· Develops, implements and evaluates the surveillance of utilization review process to

ensure quality services

· Monitors, tracks, and maintain records on compliance

· Plans and evaluates outcome studies and/or compliance findings

· Plans, develops, schedules and implements surveys and complaint investigations for

licensure or certification of regulated facilities

· Plans, organizes, and directs the certification reviews, reviews new rules and service site

applications

· Recommends programmatic and/or operational changes based on review, audit or

survey results

· Researches and analyzes state codes, federal regulations and industry manuals

regarding forms, policies and procedures

· Reviews applications for accuracy and compliance with guidelines, regulations and laws

· Performs investigations and/or audits according to established rules, regulations and

other statutes

Note: Some positions may require a certification or licensure.

Note: Some positions may require a valid driver's license.

Contact Info:

Antoria Ware

478-733-1449

Antoria.pitts@gdc.ga.gov