Job Details

Quality Assurance Specialist - MED - 24538USA:ID:Boise | Program Management | Full Time27.12 - 27.70 USD per hourPosted 3 days ago | Apply before July 27, 2026DescriptionThe Idaho Department of Health and Welfare's Division of Medicaid, Bureau of Long Term Care seeks a forward‑thinking, self‑directed, innovative team member to serve as a Quality Assurance Specialist. The role works directly with service providers, participants, stakeholders, and administration to ensure program compliance and the appropriate delivery of services administered by the Bureau of Long Term Care. You will schedule and conduct routine audits, perform targeted reviews of provider compliance, and work closely with the QA Manager, program policy staff, field staff, and Idaho Medicaid providers. This position can be located out of the Boise or Burley offices. This position is not eligible for telework.ResponsibilitiesPlan and execute provider audits to ensure compliance with IDAPA regulations and Idaho Medicaid Provider Agreements.Develop detailed audit reports that include findings, supporting evidence, identified deficiencies, recommendations for improvement, requests for Corrective Action Plans, and suggestions for enforcement of provider agreements.Communicate audit results and compliance assessments to management, offering guidance on adherence to established standards and requirements.Collect, analyze, and synthesize data from assessments and monitoring activities to evaluate compliance with relevant state and federal regulations.Assist the QA Manager in creating instructional materials, reviewing program policies and procedures, and recommending system or policy enhancements.Investigate and document complaints and critical incidents, including those involving abuse, neglect, or exploitation.Deliver provider training sessions and offer technical assistance and subject matter expertise to providers, staff, and stakeholders.Respond to public records requests and other inquiries to ensure accurate, consistent, and professional program communication.Demonstrate strong attention to detail, excellent documentation and writing skills, and effective organizational abilities.Proficiency in Microsoft Excel, Word, and PowerPoint at an intermediate level or higher is required.QualificationsMinimum QualificationsGood knowledge of medical service delivery systems, typically gained by completing at least two college courses in a medical/health services field (public health, health care administration, etc.) and having at least one year of experience applying this knowledge in a medical service delivery system or at least two years of related experience.Some knowledge of current laws and regulations governing Title XIX Medicaid programs, typically gained by one year of experience where knowledge and understanding of Title XIX Medicaid laws and regulations was a job responsibility.Some knowledge of training methods, typically gained by successful completion of coursework or workshops of 16 hours or more covering communication concepts, learning styles, course design, and presentation skills or experience in presenting formal training sessions to groups.Experience developing instructional materials, typically gained by one year of experience actually developing (not just presenting) instructional course content and materials.Experience evaluating program policies and procedures and recommending changes, typically gained by one year of job experience which included the opportunity to evaluate the employer's policies and procedures and provide input and/or recommend changes. Experience comparing employer's policies and procedures to Medicaid or other governmental regulatory requirements would qualify as experience.Preferred ExperienceExperience writing audit plans, preparing audit reports and monitoring implementation of corrective action plans.Experience in both individual and group communication techniques that involve various stakeholders, facilitation to include providing presentations, public speaking and fielding open question and answer sessions.Experience using programs such as SharePoint, Microsoft Word, PowerPoint, electronic document management systems, and Excel.BenefitsPaid sick and vacation that begins accruing on your first day of employment; can be used immediately after accruing (no waiting time)2 voluntary supplemental retirement plans including both pre‑tax and Roth optionsDeferred compensation planLife insurance for self, spouse, and childrenShort and long‑term disability insuranceFlexible Spending Accounts (FSA)Wide variety of training opportunitiesSome positions offer flexible hours and/or telecommutingIf you have questions, please contact us at:Email: dhwjobs@dhw.idaho.govPhone: (208) 334-0681EEO/ADA/Veteran: The State of Idaho is committed to providing equal employment opportunities and prohibits discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibits discrimination against all individuals based on their race, color, religion, political affiliation or belief, sex, national origin, genetics, or any other status protected under applicable federal, state, or local laws. The State of Idaho is committed to access and reasonable accommodations for individuals with disabilities. If you require an accommodation at any step in our recruitment process, you are encouraged to contact (208) 334-2263 (TTY/TTD: 711), or email ada.coordinator@dhr.idaho.gov. Preference may be given to veterans who qualify under state and federal laws and regulations.#J-18808-Ljbffr