Get your resume scored out of 100. Free ATS analysis.Rate yours
Commonwealth of Pennsylvania
Dauphin County or Harrisburg

Quality Assurance Risk Management Coordinator

Hybrid$67,736 - $102,905/yrPosted 1 week ago

We tailor your resume to this role and apply for you in seconds.

Apply to Quality Assurance Risk Management Coordinator at Commonwealth of Pennsylvania

Job details

Location
Dauphin County or Harrisburg
Work type
Hybrid
Compensation
$67,736 - $102,905/yr
Posted
1 week ago
Apply on
governmentjobs.com

About this role

About the Department

The Quality Assurance Risk Management Coordinator role with the Department of Human Services offers you the chance to make a real impact on behavioral health services across Pennsylvania. This position helps strengthen oversight, improve service quality, and support positive outcomes for individuals who rely on Medicaid behavioral health programs. It is a meaningful career path for someone who wants to support strong systems and better access to care!


Position Duties

This position helps ensure that Medicaid Behavioral Health services are delivered with quality, consistency, and accountability across the HealthChoices program. It involves reviewing data, evaluating program practices, and supporting quality improvement efforts. As a Quality Assurance Risk Management Coordinator, you will perform the following duties:

  • Compliance Reviews: Review contractor operations and documentation for alignment with state and federal requirements
  • Performance Evaluation: Assess quality management plans, evaluations, and program descriptions to confirm benchmarks and standards are met
  • Risk Identification: Identify service delivery risks through review of complaints, grievances, and service denial decisions
  • Onsite Audits: Lead onsite reviews with program partners to examine service quality, access, and adherence to medical necessity
  • Collaboration Work: Coordinate with internal teams and external partners to advance quality initiatives and improve behavioral health outcomes
  • Data Reporting: Analyze submissions and prepare written and statistical reports that highlight trends and support decision making

Interested in learning more? Additional details regarding this position can be found in the position description.


Work Schedule and Additional Information:

  • Full-time employment
  • Work hours are 8:00 AM to 4:30 PM, Monday - Friday, with a 60-minute lunch.
  • Telework: You may have the opportunity to work from home (telework) part-time. You will be required to report to 303 Walnut Street Harrisburg, PA 17101, as listed in this posting two
    days per week. In order to telework, you must have a securely configured high-speed internet connection and work from an approved location inside Pennsylvania. If you are unable to telework, you will have the option to report to the headquarters office in Harrisburg. The ability to telework is subject to change at any time. Additional details may be provided during the interview.
  • Salary: In some cases, the starting salary may be non-negotiable.
  • You will receive further communication regarding this position via email. Check your email, including spam/junk folders, for these notices.

Minimum Qualifications

QUALIFICATIONS

Minimum Experience and Training Requirements:

  • One year as a Quality Assurance/Risk Management Specialist (Commonwealth job title or equivalent Federal Government job title, as determined by the Office of Administration); or
  • Three years of professional experience as a member of a multiple disciplinary treatment team in a public or private health care facility and a bachelor's degree; or
  • Three years of clinical experience in a human services agency, including two years of administrative, evaluative, consultative or supervisory work in a health care program; and a bachelor's degree with major course work in social work, nursing, health care administration, behavioral sciences or a related field; or
  • Any equivalent combination of experience and training.

Other Requirements:

  • You must meet the PA residency requirement. For more information on ways to meet PA residency requirements, follow the link and click on Residency Guidelines. 
  • You must be able to perform essential job functions.

How to Apply:

  • Resumes, cover letters, and similar documents will not be reviewed, and the information contained therein will not be considered for the purposes of determining your eligibility for the position. Information to support your eligibility for the position must be provided on the application (i.e., relevant, detailed experience/education).
  • If you are claiming education in your answers to the supplemental application questions, you must attach a copy of your college transcripts for your claim to be accepted toward meeting the minimum requirements. Unofficial transcripts are acceptable.
  • Your application must be submitted by the posting closing date. Late applications and other required materials will not be accepted.
  • Failure to comply with the above application requirements may eliminate you from consideration for this position. 
  • All application materials and interview responses must reflect the applicant’s own experience, qualifications, and work. Applicants may use generative AI tools for preparation purposes only. Use of AI to misrepresent or falsify information, or to assist during interviews, is not permitted. Review the Guidance for Generative AI Tools & Job Seekers for additional information.

Veterans:

  • Pennsylvania law (51 Pa. C.S. §7103) provides employment preference for qualified veterans for appointment to many state and local government jobs. To learn more about employment preferences for veterans, go to www.pa.gov/agencies/employment/how-to-apply.html and click on Veterans.

Telecommunications Relay Service (TRS): 

  • 711 (hearing and speech disabilities or other individuals).

If you are contacted for an interview and need accommodations due to a disability, please discuss your request for accommodations with the interviewer in advance of your interview date.


The Commonwealth is an equal employment opportunity employer and is committed to a diverse workforce. The Commonwealth values inclusion as we seek to recruit, develop, and retain the most qualified people to serve the citizens of Pennsylvania. The Commonwealth does not discriminate on the basis of race, color, religious creed, ancestry, union membership, age, gender, sexual orientation, gender identity or expression, national origin, AIDS or HIV status, disability, or any other categories protected by applicable federal or state law. All diverse candidates are encouraged to apply.

Other Qualifications

  • Completing the application, including all supplemental questions, serves as your exam for this position. No additional exam is required at a test center (also referred to as a written exam).
  • Your score is based on the detailed information you provide on your application and in response to the supplemental questions. 
  • Your score is valid for this specific posting only.
  • You must provide complete and accurate information or:
    • your score may be lower than deserved.
    • you may be disqualified.
  • You may only apply/test once for this posting.
  • Your results will be provided via email.

Benefits

Learn more about our Total Rewards by watching this short video!


See the total value of your benefits package by exploring our benefits calculator.

Health & Wellness

We offer multiple health plans so our employees can choose what works best for themselves and their families. Our comprehensive benefits package includes health coverage, vision, dental, and wellness programs.*


Compensation & Financial Planning
We invest in our employees by providing competitive wages and encouraging financial wellness by offering multiple ways to save money and ensure peace of mind including multiple retirement and investment plan options. 

Work/Life Balance
We know there’s more to life than just work! Our generous paid leave benefits include paid vacation, paid sick leave, eight weeks of paid parental leave, military leave, and paid time off for most major U.S. holidays, as well as flexible work schedules and work-from-home opportunities.* 

Values and Culture
We believe in the work we do and provide continual opportunities for our employees to grow and contribute to the greater good. As one of the largest employers in the state, we provide opportunities for internal mobility, professional development, and the opportunity to give back by participating in workplace charitable giving.

Employee Perks
Sometimes, it is the little “extras” that make a big difference. Our employees receive special employee-only discounts and rates on a variety of services and memberships.

For more information on all of these Total Rewards benefits, please visit www.employment.pa.gov and click on the benefits box.

*Eligibility rules apply.

Supplemental Questions

01
Have you been employed by the Commonwealth of Pennsylvania as a Quality Assurance/Risk Management Specialist for one or more years full-time?
  • Yes
  • No
02
If you are claiming experience in the above question, please list the employer(s) where you gained this experience in the text box below. The employer(s) and a description of the experience must also be included in the appropriate sections of your application if you would like the experience to be considered in the eligibility decision. If you claimed you do not have experience, type N/A in the text box below.
03
How many years of full-time professional experience as a member of a multiple disciplinary treatment team in a public or private health care facility do you possess?
  • 3 years or more
  • 2 but less than 3 years
  • 1 but less than 2 years
  • Less than 1 year
  • None
04
If you are claiming experience in the above question, please list the employer(s) where you gained this experience in the text box below. The employer(s) and a description of the experience must also be included in the appropriate sections of your application if you would like the experience to be considered in the eligibility decision. If you claimed you do not have experience, type N/A in the text box below.
05
How many years of full-time clinical experience in a human services agency do you possess?
  • 3 years or more
  • 2 but less than 3 years
  • 1 but less than 2 years
  • Less than 1 year
  • None
06
If you are claiming experience in the above question, please list the employer(s) where you gained this experience in the text box below. The employer(s) and a description of the experience must also be included in the appropriate sections of your application if you would like the experience to be considered in the eligibility decision. If you claimed you do not have experience, type N/A in the text box below.
07
Do you possess two or more years of full-time administrative, evaluative, consultative clinical experience or supervisory work in a health care program?
  • Yes
  • No
08
If you are claiming experience in the above question, please list the employer(s) where you gained this experience in the text box below. The employer(s) and a description of the experience must also be included in the appropriate sections of your application if you would like the experience to be considered in the eligibility decision. If you claimed you do not have experience, type N/A in the text box below.
09
How much graduate coursework have you completed in social work, nursing, health care administration, behavioral sciences, or a related field?

If you are claiming credits/degree, you must upload a copy of your college transcript(s) for this education to be considered in the eligibility decision. Unofficial transcripts are acceptable. You must attach your transcript(s) prior to the submission of your application by using the "Attachments" tab on the left. You will not be able to add a transcript(s) to the application after it has been submitted.

If your education was acquired outside of the United States, you must upload a copy of your foreign credential evaluation report. We can only accept foreign credential evaluations from organizations that are members of the National Association of Credential Services (NACES). A list of current NACES members can be found by visiting www.naces.org and clicking the Evaluation Services Link.

You must attach your documentation prior to the submission of your application by using the "Attachments" tab on the left. You will not be able to add a document to the application after it has been submitted.
  • 30 credits or more
  • Less than 30 credits
  • None
10
You must complete the supplemental questions below. These supplemental questions are the exam and will be scored. They are designed to give you the opportunity to relate your experience and training background to the major activities (Work Behaviors) performed in this position. Failure to provide complete and accurate information may delay the processing of your application or result in a lower-than-deserved score or disqualification. You must complete the application and answer the supplemental questions. Resumes, cover letters, and similar documents will not be reviewed for the purposes of determining your eligibility for the position or to determine your score.

All information you provide on your application and supplemental questions is subject to verification. Any misrepresentation, falsification or omission of material facts is subject to penalty. If requested, you must provide documentation, including names, addresses, and telephone numbers of individuals who can verify the validity of the information you provide in the application and supplemental questions.

Read each question carefully. Determine and select which "Level of Performance" most closely represents your highest level of experience/training. List the employer(s)/training source(s) from your Work or Education sections of the application where you gained this experience/training. The "Level of Performance" you choose must be clearly supported within the description of the experience and training information entered in your application or your score may be lowered. In order to receive credit for experience, you must have worked in a job for at least six months in which the experience claimed was a major function.

If you have read and understand these instructions, please click on the "Yes" button and proceed to the exam questions.

If you have general questions regarding the application and hiring process, please refer to our FAQ page.
  • Yes
11
WORK BEHAVIOR 1 - DEVELOPS/IMPLEMENTS QUALITY MANAGEMENT/PERFORMANCE IMPROVEMENT PLANS

Develops and implements quality management and performance improvement plans and direct-action plans. Establishes priorities and ensures compliance by reading and interpreting related federal, state, and accrediting agencies' rules, regulations, policies, and procedures. Educates staff on new or changing requirements and provides data to interested parties as necessary.

Levels of Performance

Select the Level of Performance that best describes your claim.
  • A. I have experience developing and implementing quality management and performance improvement plans or direct-action plans. I was responsible for ensuring compliance with established rules, regulations, policies, and procedures.
  • B. I have experience implementing quality management and performance improvement plans or direct-action plans that were developed by someone else. I was responsible for ensuring compliance with established rules, regulations, policies, and procedures.
  • C. I have successfully completed college-level coursework related to strategic or program planning.
  • D. I have NO experience or training related to this work behavior.
12
In the text box below, please describe your experience as it relates to the level of performance you claimed in this work behavior. Please be sure your response addresses the items listed below which relate to your claim. If you indicated you have no work experience related to this work behavior, type N/A in the box below.
  1. The name(s) of the employer(s) where you gained this experience.
  2. The actual duties you performed related to developing/implementing quality management/performance plans.
  3. The type(s) of quality management/performance plans you developed/implemented.
  4. Your level of responsibility.
13
If you have selected the level of performance pertaining to college coursework, please provide your responses to the three items listed below. If you indicated you have no education/training related to this work behavior, type N/A in the text box below.
  1. College/University
  2. Course Title
  3. Credits/Clock Hours
14
WORK BEHAVIOR 2 – EVALUATES QUALITY MANAGEMENT/PERFORMANCE IMPROVEMENT PLANS

Analyzes incident and other related performance indicator data utilizing available sources such as electronic data base systems, software, reports, literature, questionnaires, and charts for the purpose of establishing baseline performance and determining areas in need of quality improvement and/or risk mitigation.

Levels of Performance

Select the Level of Performance that best describes your claim.
  • A. I have experience analyzing incident and other related data to establish baseline performance and determine areas in need of improvement and/or risk mitigation. I was responsible for providing recommendations for changes.
  • B. I have experience analyzing incident and other related data to establish baseline performance and determine areas in need of improvement and/or risk mitigation. I did NOT provide recommendations for changes.
  • C. I have successfully completed college-level coursework related to program evaluation.
  • D. I have NO experience or training related to this work behavior.
15
In the text box below, please describe your experience as it relates to the level of performance you claimed in this work behavior. Please be sure your response addresses the items listed below which relate to your claim. If you indicated you have no work experience related to this work behavior, type N/A in the box below.
  1. The name(s) of the employer(s) where you gained this experience.
  2. The type(s) of incident and performance data you analyzed.
  3. The recommendations you provided.
  4. The actual duties you performed.
  5. Your level of responsibility.
16
If you have selected the level of performance pertaining to college coursework, please provide your responses to the three items listed below. If you indicated you have no education/training related to this work behavior, type N/A in the text box below.
  1. College/University
  2. Course Title
  3. Credits/Clock Hours
17
WORK BEHAVIOR 3 - DEVELOPS AND IMPLEMENTS EVALUATION SYSTEMS/TOOLS

Develops and implements systems/tools to monitor quality assurance or risk management plans. Interviews staff and individuals served and utilizes other acceptable evaluation tools, such as audit reports and quality assurance checklists, to review and monitor program operations. Areas of focus may include risk/incident management plans, focus group work plans, policies, procedures, and completion timetables for quality assurance/risk management activities implemented by other departments.

Levels of Performance

Select the Level of Performance that best describes your claim.
  • A. I have experience developing AND implementing systems/tools to monitor quality assurance or risk management plans. I was responsible for ensuring the plans stay on task and within the proposed timeline.
  • B. I have experience implementing systems/tools to monitor quality assurance or risk management plans that were developed by someone else. I was responsible for ensuring the plans stay on task and within the proposed timeline.
  • C. I have experience utilizing systems/tools to monitor quality assurance or risk management plans.
  • D. I have successfully completed college-level coursework related to quality assurance or risk management.
  • E. I have NO experience or training related to this work behavior.
18
In the text box below, please describe your experience as it relates to the level of performance you claimed in this work behavior. Please be sure your response addresses the items listed below which relate to your claim. If you indicated you have no work experience related to this work behavior, type N/A in the box below.
  1. The name(s) of the employer(s) where you gained this experience.
  2. The actual duties you performed related to developing, implementing, or utilizing evaluation systems or tools.
  3. Your level of responsibility.
19
If you have selected the level of performance pertaining to college coursework, please provide your responses to the three items listed below. If you indicated you have no education/training related to this work behavior, type N/A in the text box below.
  1. College/University
  2. Course Title
  3. Credits/Clock Hours
20
WORK BEHAVIOR 4 - PROVIDES GUIDANCE AND TECHNICAL ASSISTANCE

Provides guidance, technical assistance, and training to system improvement teams by utilizing available performance improvement data to demonstrate known performance improvement practices such as root cause analysis, proactive risk assessment, plan-do-check-act activities, and other known quality management methodologies used to develop, implement, and/or monitor action plans and services to minimize risk, correct deficiencies, and improve quality.

Levels of Performance

Select the Level of Performance that best describes your claim.
  • A. I have conducted presentations to provide information and demonstrations on performance improvement practices and other known quality management methodologies to minimize risk, correct deficiencies, and improve quality.
  • B. I have responded to inquiries regarding performance improvement practices and other known quality management methodologies to minimize risk, correct deficiencies, and improve quality.
  • C. I have successfully completed college-level coursework related to training or public speaking.
  • D. I have NO experience or training related to this work behavior.
21
In the text box below, please describe your experience as it relates to the level of performance you claimed in this work behavior. Please be sure your response addresses the items listed below which relate to your claim. If you indicated you have no work experience related to this work behavior, type N/A in the box below.
  1. The name(s) of the employer(s) where you gained this experience.
  2. The subject matter of the presentations you provided.
  3. The audience to whom you presented.
  4. The types of inquiries to which you responded.
  5. The actual duties you performed.
22
If you have selected the level of performance pertaining to college coursework, please provide your responses to the three items listed below. If you indicated you have no education/training related to this work behavior, type N/A in the text box below.
  1. College/University
  2. Course Title
  3. Credits/Clock Hours

Required Question

Agency Information

EmployerCommonwealth of PennsylvaniaAddress 613 North Street

Harrisburg, Pennsylvania, 17120 Website http://www.employment.pa.gov
Ready to apply?
We tailor your resume to this role and apply for you.

About Commonwealth of Pennsylvania

Commonwealth of Pennsylvania
Dauphin County or Harrisburg
WebsiteLinkedIn