The Director of Quality Assurance provides strategic leadership and operational oversight to ensure the organization's services meet all applicable agency, state and federal standards. This position develops, implements, and continuously improves the organization's quality management systems.
- Maintain thorough knowledge of and ensure compliance with all applicable South Dakota Administrative Rules and all Division of Developmental Disabilities (DDD) policies.
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Oversee certification and recertification per DDD requirements.
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Lead for DDD reviews, including SMART audits, and manage any resulting corrective action plans.
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Monitor Centers for Medicaid (CMS) Home and Community Based Services (HCBS) Settings Rule requirements and ensure all residential and day service settings maintain compliance with person-centered, community-integrated standards.
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Ensure record retention complies with applicable state and Medicaid standards, maintaining participant medical and financial records for a minimum of six years.
- Develop and implement an organization-wide Quality Management plan aligned with the Council of Quality and Leadership (CQL) Basic Assurances and Personal Outcome Measures.
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Lead internal quality reviews across residential, employment, day services, shared living, and programmatic services.
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Establish and monitor key performance indicators for service quality, health outcomes, safety, and regulatory compliance.
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Prepare and present quality data reports as requested by Senior Leadership.
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Identify trends, gaps and areas for training and improvement and present to leadership with recommendations.
- Serve as the organization's lead administrator and subject matter expert for Therap.
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Oversee the accurate and timely entry of required documentation in Therap, including General Event Reports (GERs), Individual Support Plans (ISPs), T- logs, and other participant records.
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Ensure all staff with Therap access are properly trained and that documentation practices meet DDD standards and state reporting requirements.
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Monitor Therap records for completeness, accuracy, and compliance; identify documentation deficiencies and implement corrective measures.
- Champion person-centered practices across all service delivery and documentation, consistent with HCBS waiver requirements and the philosophy of self-determination.
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Oversee participant rights policies and grievance and complaint resolution processes.•
- Oversee the accuracy and completeness of service documentation across all programs to ensure alignment with South Dakota Medicaid billing requirements and the CHOICES Waiver fee schedule.
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Conduct regular audits of service records, progress notes, and billing documentation to verify that services delivered are accurately reflected, properly authorized, and billable under applicable Medicaid standards.
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Collaborate with billing and finance staff to identify and resolve documentation gaps or discrepancies that may affect reimbursement or create compliance risk.
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Ensure that all program documentation meets South Dakota Medicaid medical records standards, including legibility, timeliness, and service verification.
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Monitor DDD service authorizations and ensure documentation supports the level and type of services billed under each participant's ISP.
- Assist with the development, review, and revision of organization-wide policies and procedures to ensure ongoing alignment with DDD directives, CMS HCBS standards, and best practices in I/DD services.
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Participate with policy review committee to ensure all policies are evaluated at least annually and updated promptly in response to regulatory changes.
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Collaborate with program directors, HR, and leadership to develop operational procedures that reflect current standards and promote consistent, high-quality service delivery.
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Work with policy committee to ensure that new and revised policies are communicated effectively to staff and integrated into training and onboarding processes.
- Bachelor's degree in Human Services, Social Work, Psychology, Healthcare Administration, Public Administration, Accounting or a related field.
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Prefer three (3) years of experience in quality assurance, compliance, or program management serving individuals with intellectual and/or developmental disabilities
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Experience with the Therap documentation system
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Strong understanding of ARSD, CQL Basic Assurances, Personal Outcome Measures, and HCBS settings requirements.
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Excellent written and verbal communication skills; ability to prepare regulatory reports and present findings to leadership and external stakeholders.
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Ability to teach curriculum development, assess staff competencies resulting in increased compliance with agency, state and federal standards.
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Demonstrated ability to analyze data, identify trends, and implement continuous quality improvement initiatives.
Black Hills Works Inc. is an equal opportunity employer and will consider all qualified applicants for employment without regard to race, color, religion, gender, gender identity, sexual orientation, national origin, disability status, protected veteran status, or any other characteristic protected by law.
