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QUALITY ASSURANCE MANAGER
The Quality Assurance Manager is responsible for directing the operation of the quality assurance unit within the agency. This position is governed by state and federal laws and agency/institution policy.
Class Code:
X038C
Job Grade:
GS09
Special Job Requirements:
None
Typical Functions:
Supervises professional and administrative support staff by interviewing and recommending for hire, assigning and reviewing work, training new employees, and evaluating the performance of incumbents. Analyzes cases returned as errors by federal and state quality assurance reviewers, determines accuracy of errors, evaluates agency compliance with Social Security regulations and policy, and ensures corrective action taken in federal quality assurance cases. Coordinates agency disability rebuttals of federal quality assurance errors, and resolves conflicts with operations supervisors and medical consultants involving errors identified by agency quality assurance unit. Provides technical assistance to agency personnel regarding quality assurance policies and procedures. Compiles information from state and federal quality assurance case samples into reports summarizing deficiencies, including medical consultant errors and adjudicator substantive and technical accuracy. Develops agency policies, procedures, and standards related to quality of disability cases. May initiate special studies to ensure program compliance with state and federal laws and guidelines. Attends various meetings regarding quality assurance and serves as a liaison between the Social Security Disability program policy coordinators and other state and federal agencies. Performs other duties as assigned.
Knowledge, Abilities, and Skills:
Knowledge of state and federal laws, rules, and regulations governing social security disability. Knowledge of case management. Knowledge of departmental policies, procedures, and guidelines governing social security disability. Ability to plan, organize, and direct the work of others. Ability to analyze medical reports and apply complex eligibility criteria to ensure quality is maintained. Ability to review, organize, and present oral and written information. Ability to plan, develop, implement, and evaluate the effectiveness of social security disability programs and services.
Minimum Qualifications:
The formal education equivalent of a bachelor’s degree in general business, sociology, or a related field; plus four years of experience in quality assurance or a related field, including one year in a leadership capacity. Additional requirements determined by the agency for recruiting purposes require review and approval by the Office of Personnel Management. OTHER JOB RELATED EDUCATION AND/OR EXPERIENCE MAY BE SUBSTITUTED FOR ALL OR PART OF THESE BASIC REQUIREMENTS, EXCEPT FOR CERTIFICATION OR LICENSURE REQUIREMENTS, UPON APPROVAL OF THE QUALIFICATIONS REVIEW COMMITTEE
Required Certificates:
None
Exempt:
E
