Quality Review Specialist III

🔥 4 minutes ago

🐊 Florida – Remote

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💵 $53k - $59k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👻 Ghost score 0%

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Logo of Qlarant

Qlarant

501 - 1000 employees

Founded 1973

🏥 Healthcare

💼 Consulting

🛡️ Insurance

Healthcare • Consulting • Insurance

Qlarant is a US-based services and technology firm specializing in healthcare program integrity, offering quality improvement, fraud, waste & abuse (FWA) detection and investigative services, and advanced data analytics and predictive modeling tools (the RIViR® Risk Solution Suite) for government agencies, health plans, and related sectors. The company also operates initiatives like the Qlarant Foundation and Qlarant Capital to fund grants and early-stage startups, and provides pharmacy, drug pricing, and transportation-focused solutions.

📋 Description

• Facilitate routine evaluations assessing whether individuals with intellectual developmental disabilities receive customized support and services • Conduct scheduled reviews of IDD service providers’ effectiveness in preserving individuals’ health and safety • Administer detailed program and service-provider evaluations against established standards • Identify improvement areas and collaborate with stakeholders on quality-enhancement initiatives • Inspect provider documentation, reports, and records • Advocate for the rights and well-being of individuals with developmental disabilities • Analyze program outcomes, client satisfaction, and other metrics • Communicate with service providers, agencies, and stakeholders • Develop and provide technical assistance, training, and guidance on best practices, quality standards, and compliance • Take immediate action in cases of abuse, neglect, or exploitation according to established protocols • Conduct respectful interviews with service recipients and provider staff • Document review findings and generate reports • Plan and arrange own work while working with a manager to prioritize projects

🎯 Requirements

• Minimum Bachelor's Degree required (can be substituted for experience) • 5 - 7 years of experience required; 8 - 11 years preferred • Must meet the criteria to be a Developmental Disabilities Professional (DDP) and Qualified Intellectual Disabilities Professional (QIDP) • Successful completion of pre-employment background and drug screens • Must comply with relevant laws, regulations, and policies related to developmental disabilities

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