PACE Quality Assurance Analyst

Community health is about more than just vaccines and checkups. It’s about giving people the resources they need to live their best lives. At Neighborhood, this is our vision. A community where everyone is healthy and happy. We’re with you every step of the way, with the care you need for each of life’s chapters. At Neighborhood, we are Better Together.

Neighborhood Healthcare PACE is a managed medical plan built around surrounding participants with a team of physicians, nurses, social workers, therapists and care coordinators to help them maintain good health and a good quality of life. Our goal is to keep our seniors happy and healthy at home surrounded by their family and community.

As a private, non-profit 501(C) (3) community health organization, we serve over 500k medical, dental, and behavioral health visits from more than 100,000 people annually. With two PACE centers located in Riverside County, our PACE program is positioned to serve over 650 senior participants.

The PACE Quality Assurance (QA) Analyst will ensure top notch healthcare standards for our geriatric community. This role will investigate incidents and implement performance improvement plans as it pertains to infection control, service delivery requests (SDR), appeals, and grievance resolutions. 

Schedule: Monday-Friday, 8am-5pm. This position is onsite.

Responsibilities

• Validates comprehensive data collection from relevant sources and communicates findings to stakeholders
• Conducts thorough incident report investigations, including Level II incidents, requiring in-depth root cause analysis (RCA) to identify contributing factors and prevent recurrence
• Develops and monitors a quality assessment and performance improvement plan (QAPI) under the supervision of the Medical Director, including the annual plan and its implementation
• Develops and implements the annual infection control plan and maintains an infection control program that investigates, controls, and prevents infections promptly
• Monitors, tracks, evaluates, and resolves medical and non-medical grievances, SDR’s, and appeals by participants, their families, and/or representatives
• Conducts complete chart audits to ensure participant care plans accurately reflect the services and care provided
• Identifies high-risk participants and refers them to appropriate medical leadership
• Facilitates quality assurance-related communication between contract facilities and PACE Interdisciplinary Teams
• Conducts quality assurance audits of contract facilities to ensure quality participant care
• Participates in orientation sessions and conducts onsite inspections of contracted facilities for quality assurance purposes
• Assists in developing agendas and leads Participant Advisory Committee meetings in the facilitator's absence
• Ensures staff integration into the QAPI process through continuous quality improvement education and opportunities for input
• Monitors participants' physical, mental, emotional, and social functioning; reports any changes to the licensed nurse
• Extracts quality data indicators from statistical data for quarterly submission to CMS
• Conducts participant and caregiver satisfaction surveys and reports findings on an annual basis
• Maintains confidentiality of company procedures, results, and participant/client/family information
• Practices universal precautions and adheres to infection control procedures
• Demonstrates warmth and responsiveness to all customer groups and supports the healthcare team's success
• Participates in continuing education and required staff training meetings

Qualifications

Education/Experience

• Bachelor’s degree in nursing, public health, or related field or an equivalent combination of education and experience required
• Valid CA nursing license (LVN or higher) preferred
• Nonlicensed personnel: Current Basic Life Support (BLS) certification required upon hire and must be maintained as a condition of employment. These courses must follow AHA guidelines- may be completed through approved online providers such as ProMed or other equivalent programs that meet recognized BLS standards
  • In addition, current CPR and First Aid certification are required for all PACE employees in accordance with CMS and DHCS requirements. First Aid training will be provided at onboarding and must be renewed annually 
• Licensed personnel: Current Basic Life Support (BLS) certification through an American Heart Association (AHA)-approved source is required upon hire and must be maintained as a condition of employment<