Job Title: RN - Utilization Review / Quality Assurance Analyst (QAA)
Location: New York, NY
Duration: 10/26/2026 – 12/19/2026
Shift: 9:00 AM-5:00 PM | 3 Days/Week | 11.50 Hours/Day | 34.50 Hours/Week
Pay range - $60/hr - $65/hr.

SUMMARY OF DUTIES AND RESPONSIBILITIES

Under direction of the Associate Executive Director (AED), the Quality Assurance Analyst (QAA) will support the quality review and evaluation of care coordination (CC) records. The QAA will assume responsibility for supporting the Division's quality improvement initiatives and compliance with regulatory requirements. The QAA will be responsible for the completion of care coordination chart audit activities, execution of corrective action plans, and support in development of training materials designed to remove any perceived gaps. The QAA will support the management of incident reporting and fair hearing activities and is primarily responsible for processing all case enrollment status changes in the Electronic Medical Record (EMR) for our care management agency.

SUMMARY OF DUTIES AND RESPONSIBILITIES

1. Conduct regular independent reviews for the client care management agency using standardized chart review tool(s) to review documentation activities (charts) for quality, completeness and compliance with all federal, state, local, and agency regulations.
2. Assist with the execution and monitoring of written action plans that identify a specific, measurable, attainable set of activities designed to improve any deficits observed in documentation/records in collaboration with the quality manager.
3. Monitor the completion of corrective action chart reviews and escalate any past-due or clinically compromising outcomes to the quality manager to ensure resolution is achieved.
4. Review and track all incoming incident, grievance, complaint and fair hearing reports to ensure accuracy and completeness. Ensure that documentation around the incident, grievance, and/or fair hearing is conducted accurately. Escalate reports that require further investigation to manager for review. Complete chart reviews for any incidents, grievances, and fair hearing and verify that recommended follow up/corrective action is completed by Client dates as appropriate to federal/state/local policy.
5. Enter all received incidents and complaints in the proper system of record (e.g. VOICE, department tracker). Maintain and prepare metrics reports to demonstrate trends in incidents/complaints.
6. Participate and document incident, grievance, and complaint case conferences to provide support and guidance to team; ensure that patients are connected to appropriate levels of care and that all required/supporting documentation is on record as needed.
7. Co-author quarterly QAPI Board Report showcasing divisional progress across KPIs and Objectives & Key Results (OKRs). Support tracking of all needed report metrics and follow up with business leaders.
8. Support Divisional QAPI committee preparation (e.g. tracking attendance, agenda development, minutes, follow up action items, etc.).
9. Maintain positive partnerships with all colleagues and team members (inter and intra departmental). Support the design of shared programmatic goals and development/application of interventions and projects to achieve those goals.
10. Support development and delivery of staff training/education as needed to improve QA/QI outcomes. Support the development and implementation of new policies, processes and procedures designed to improve the overall workflows.
11. Participate in creation and implementation of needed trainings to support Care Management Agency in deficient areas. Assist in monitoring attendance of required trainings and conducting follow up with agencies not in compliance.
12. Extract patient satisfaction survey data from Press Ganey portal and provide data processing, staging, and analysis for delivery to identified manager(s).
13. Maintain expertise in working within the assigned Electronic Health Record System(s) of the agency.
14. May attend outside meetings or conferences and or other duties as deemed necessary.
15. Other duties as assigned.

EDUCATIONAL LEVEL:

Bachelor's degree in healthcare administration, social work, nursing or related field.

KNOWLEDGEABLE IN:

Developing, implementing and evaluating quality improvement initiatives. Excellent analytical, problem solving, and decision-making skills. Strong attention to detail.

EQUIPMENT/MACHINES OPERATED:

Printer/Scanner/Copier/Fax machine, Laptop/Tablet

COMPUTER PROGRAMS/SOFTWARE OPERATED:

Required: Microsoft Office Suite (Excel, Outlook, PowerPoint, Word), WebEx and Epic Medical Record System. Preferred: Tableau

YEARS OF EXPERIENCE:

• One years' experience in quality improvement, patient safety or related field community healthcare setting preferred; or