PCM Evaluation Department- Quality Assurance and Assistant Scheduler in Stoughton, Massachusetts at Tempus Unlimited Inc.

PCM Evaluation Department -Quality Assurance and Assistant Scheduler

Summary/Objective: This position is part of our PCA program at Tempus Unlimited. This position supports the Personal Care Management (PCM) evaluation team with, quality assurance, scheduling initial and re-evaluations. Primary role is to execute daily Quality Assurance (QA) workflows for MassHealth Personal Care Attendant (PCA) evaluations, verify system data accuracy, and maintain consumer records prioritize appointments via date ranges, organize geography, and communicate with internal clinical staff of RNs and OTS, facilities, and consumers/ surrogates. Must be able to manage electronic calendar appointments, and various forms of communication effectively and efficiently.

Essential Functions

• Perform mandatory daily audits of RN and OT digital folders to ensure all newly submitted MassHealth PCA evaluations are captured and processed immediately.
• Verify and log evaluation receipt dates into the Zuke system daily
• Actively review paperwork for completeness; directly communicate with clinicians (RNs/OTs) if documentation is missing, incomplete, or requires corrections before submission.
• Coordinate directly with the Prior Authorization (PA) department to formally communicate when audited evaluations are completely accurate and ready for final submission.
• Assign initial evaluations to a Registered Nurse (RN)/Licensed Practical Nurse (LPN) and Occupational Therapist (OT) team
• Schedule Initial evaluations with consumer/surrogate
• Schedules for re-evaluations as needed.
• Outreach to those who are “On Hold” to stay up to date of their resumption of the program.
• Enter evaluation time, date and location on initial calendar and duplicate info on each RN and OT personal schedule calendar. Add re-evals to the calendar as needed.
• Call consumer/surrogate daily to confirm evaluations scheduled for the next day
• Communicate with evaluation teams of any changes to their schedules due to cancelations etc. noting all changes on initial calendar for tracking, add progress note in Zuke database.
• Create Electronic folder for all initial evaluations with adding all required and applicable documents
• Create a Monthly Initial Calendar for evaluation scheduling after input of time off requests. Duplicate info on all RN and OT calendars
• Weekly Tracking Report of initial status for Department Manager
• Document a progress note for all calls, email, or other communication in Zuke.
• Other duties as assigned.

Competencies

• Computer skills- MS Word, Excel
• Good written and verbal skills
• Strong organizational skills
• Accuracy and attention to detail
• Ability to multitask
• Adaptability/flexibility
• Self-motivated
• Perform all other duties as may be required.

Required Experience

• Previous administrative support experience

Required Education

• High School Diploma

Work Environment

• This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers and scanners.

Physical Demands

• The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.
• While performing the duties of this job, the employee is regularly required to talk and/or hear. The employee is frequently required to sit; stand; walk; use hands and fingers and also must be able to reach with hands and arms.
• lift, push, pull up to ten to fifteen pounds
• communicate with consumers and coworkers

Travel

• No travel is required for this position.

Other Duties

Note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

Communicate with internal clinical staff of RNs and OTS, facilities, and consumers/ surrogates. Must be able to manage electronic calendar appointments, and various forms of communication effectively and efficiently.

Essential Functions

• Assign initial evaluations to a Registered Nurse (RN) and Occupational Therapist (OT) team
• Schedule Initial evaluations with consumer/surrogate
• Schedules re-evaluations as needed.
• Outreach to those who are “On Hold” to stay up to date of their resumption of the program.
• Enter evaluation time, date and location on initial calendar and duplicate info on each RN and OT personal schedule calendar. Add re-evals to the calendar also as needed.
• Call consumer/surrogate daily to confirm evaluations scheduled for the next day
• Communicate with evaluation teams of any changes to their schedules due to cancelations etc. noting all changes on initial calendar for tracking, add progress note in Zuke database.
• Create Electronic folder for all initial evaluations with adding all required and applicable documents
• Create a Monthly Initial Calendar for evaluation scheduling after input of time off requests. Duplicate info on all RN and OT calendars
• Weekly Tracking Report of initial status for Department Manager
• Document a progress note for all calls, email, or other communication in Zuke.
• Other duties as assigned.

Competencies

• Computer skills- MS Word, Excel
• Good written and verbal skills
• Strong organizational skills
• Accuracy and attention to detail
• Ability to multitask
• Adaptability/flexibility
• Self-motivated
• Perform all other duties as may be required.

Required Experience

• Previous administrative support experience

Required Education

• High School Diploma

Work Environment

• This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers and scanners.

Physical Demands

• The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.
• While performing the duties of this job, the employee is regularly required to talk and/or hear. The employee is frequently required to sit; stand; walk; use hands and fingers and also must be able to reach with hands and arms.
• lift, push, pull up to ten to fifteen pounds
• communicate with consumers and coworkers

Travel

• No travel is required for this position.

Other Duties

Note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

Benefits

Tempus Unlimited offers great benefits that foster a happy fulfilling human work experience. We also have an array of growth opportunities for our employees to develop your career and enhance your experience.

• Sign on bonus
• Work/Life Balance
• Paid time off - 25 days per year for full time staff
• 14 paid Holidays
• Tempus Wellness - Medical, Dental, Dependent Care Reimbursement, FSA and HSA
• Basic Life, Short Term and Long-Term Disability
• On-site gym (Stoughton Location) and wellness initiatives
• Annual Reviews with merit-based increases
• Employee Recognition Program
• Financial Wellness - 403(b) Retirement Plan with matching
• Continuing Education, Training and Advancement opportunities

Work Authorization/Security Clearance

All offers of employment made by Tempus Unlimited are contingent upon satisfactory background check results. Pre-employment background checks will be conducted on all candidates that are offered a position at the agency in compliance with program policy as well as state and federal regulations. From time to time, these checks may be conducted on current employees to ensure compliance with all state and federal regulations and contracts.

EEO Statement

Equal Employment Opportunity is a fundamental principle at Tempus Unlimited, Inc. where employment from recruiting through the end of employment is based upon professional capabilities and qualifications without discrimination because of race, color, religion, sex, age, sexual orientation, veteran status, national origin, disability or any other characteristic as established by law. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job functions.