QA Compliance Reviewer

Date: Feb 21, 2025

Location:

ARLINGTON, TX

Join the Texas Health and Human Services Commission (HHSC) and be part of a team committed to creating a positive impact in the lives of fellow Texans. At HHSC, your contributions matter, and we support you at each stage of your life and work journey. Our comprehensive benefits package includes 100% paid employee health insurance for full-time eligible employees, a defined benefit pension plan, generous time off benefits, numerous opportunities for career advancement and more. Explore more details on the Benefits of Working at HHS webpage.

Functional Title: QA Compliance Reviewer	Job Title: Compliance Reviewer
Agency: Health & Human Services Comm	Department: Compliance & Oversight
Posting Number: 3427	Closing Date: 03/07/2025
Posting Audience: Internal and External	Occupational Category: Protective Services
Salary Group: TEXAS-B-21	Salary Range: $4,523.16 - $7,253.83
Shift: Day	Additional Shift:
Telework: Part-Time	Travel: Up to 45%
Regular/Temporary: Regular	Full Time/Part Time: Full time
FLSA Exempt/Non-Exempt: Nonexempt	Facility Location:
Job Location City: ARLINGTON	Job Location Address: 1540 NEW YORK AVE

Other Locations:

MOS Codes:

6016,6017,6033,8012,8056,1S0X1,2A7X2,2F0X1,43HX,4E0X1,640A,68R,86M0,87G0,87I0,87Q0,8I000,8I100,8S000

AD,AM,AME,BOSN,HT,IV,ME,MSSD,MSSE,MSSR,MST,OAP11,OAP14

Job Description:	This position’s headquarters can be located in any available HHSC LTCR office in the state of Texas. Under the supervision of the Quality Assurance Regional Programs (QARP) Manager, the QARP Compliance Reviewer (CR) reviews certification and licensure forms that resulted in a deficient practice for Home and Community-based Services (HCS) and Texas Home Living (TxHmL)Waiver Programs. The QARP CR participates in review committees, prepares data for review, and assists in identifying regional trends and patterns. Performs advanced technical and professional reviews of certification surveys, licensure inspections, and investigations conducted in long term care facilities to determine compliance with state/federal requirements and protocols, and Long-Term Care-Regulatory (LTCR) policies and procedures. Transforms qualitative data into quantitative data and may assist with in-depth analysis of qualitative and quantitative program-specific data. Interprets statistical evidence and develops work plans, reports, and documentary support for program development and assessment.

Essential Job Functions:	Performs advanced technical and professional reviews of survey forms to ensure appropriateness and completeness based on the Principles of Documentation (PoD), The Centers for Medicaid and Medicare Services (CMS) State Operations Manual (SOM), compliance with state/federal regulations, and Long-term Care-Regulatory policies and procedures. Consults with regional surveyors, program managers, and other regional staff to clarify any discrepancies and works with the regional staff to recommend appropriate corrections. Assists in compiling of data to show trends resulting from the QA review. Provides ongoing education, both onsite and virtually, to surveyors and regional management. Maintains professional and technical knowledge for LTCR programs. Excellent communication skills including the ability to manage self remotely. Maintains a regular and predictable work schedule.

Registrations, Licensure Requirements or Certifications:	N/A

Knowledge Skills Abilities:	Knowledge of any specialized program area in Long-term Care Regulatory. Knowledge of the principles and methods of field inspection, investigation, or quality control from any of the following program areas: HCS and TxHmL Waiver Program including Residential Support Services, Supported Living, Host Home Companion Care, and Own Home/Family Home services preferred. Knowledge of investigations and determining proper courses of action. Skill in using Microsoft Office software: Word, Excel, and Outlook. Ability to work in a professional team environment; Ability to organize workloads and set priorities to meet deadlines and function with minimal supervision; Ability to prepare concise reports.

Initial Screening Criteria:	Experience in any Long-Term Care Regulatory program. (Home Health, ICF/IID, Health Facilities, HCS and TxHmL Waiver Programs, or Assisted Living Facilities). HCS and TxHmL Waiver Programs or Assisted Living Facility Programs preferred. Bachelor’s Degree in a Social Services or related Field.

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Active Duty, Military, Reservists, Guardsmen, and Veterans:

Military occupation(s) that relate to the initial selection criteria and registration or licensure requirements for this position may include, but not limited to those listed in this posting. All active-duty military, reservists, guardsmen, and veterans are encouraged to apply if qualified to fill this position. For more information please see the Texas State Auditor’s Job Descriptions, Military Crosswalk and Military Crosswalk Guide at Texas State Auditor's Office - Job Descriptions.

ADA Accommodations:

In compliance with the Americans with Disabilities Act (ADA), HHSC and DSHS agencies will provide reasonable accommodation during the hiring and selection process for qualified individuals with a disability. If you need assistance completing the on-line application, contact the HHS Employee Service Center at 1-888-894-4747. If you are contacted for an interview and need accommodation to participate in the interview process, please notify the person scheduling the interview.

Pre-Employment Checks and Work Eligibility:

Depending on the program area and position requirements, applicants selected for hire may be required to pass background and other due diligence checks.

HHSC uses E-Verify. You must bring your I-9 documentation with you on your first day of work. Download the I-9 Form