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Form of workJob Description
OVERVIEW: CASES is looking for a Quality Improvement professional experienced in the treatment of people with serious mental illnesses, to lead a team responsible for compliance, quality assurance, and Quality Improvement. The director will bring expertise knowledge about NYS Office of Mental Health (OMH) licensed mental health treatment programs regulations and standards of care, Medicaid, NYS Office of the Medicaid Inspector General (OMIG) compliance plans, and the NYS Justice Center for the Protection of People with Special Needs policies and procedures. The position works closely with the Compliance & Privacy Officer and Senior Directors ensuring regulatory and program contract compliance. The ideal candidate is a responsive and service-oriented team member who thrives on evidence-based approaches to monitor compliance and promote quality. The role manages the integrated and coordinated approach to Quality Improvement throughout CASES. The Director will manage areas of Quality Improvement strategy and execution by building systems that sustain a culture of continuous Quality Improvement to improve client experiences and client outcomes. This is a remote position working when needed in-person to deliver staff training, and to participate in meetings and government site visit audits. When working in-person the director will be onsite at our Central Harlem, South Bronx, Downtown Manhattan, and Downtown Brooklyn locations.
WHAT YOU WILL BE DOING:
Assess the performance and compliance of the mental health treatment programs with licensing standards of care and Medicaid regulations, conduct documentation audits, and coordinate Quality Improvement and corrective action initiatives to improve client safety, the effectiveness, timeliness, and person-centeredness of the treatment and rehabilitation services.
Oversee incident management for the licensed programs according to NYS Part 524 regulations, and the incident management for youth, pretrial and alternative to incarceration programs: promoting effective staff training, engaging and helpful incident review meetings, follow-up procedures and practices, and annual trend analysis reports.
Serve as Special Investigator for significant participant events including reports made to the Justice Center for clients in licensed programs and promote client rights with the effective management of the client grievance process ensuring the timely review and resolution of individual complaints.
Prepare quarterly reports for Compliance Committee and the licensed programs Governing Body on the status of program performance, (client incident reports, licensing audits, Medicaid fraud, waste, abuse).
Oversee the utilization review (UR) process for admission, continuing stay, and discharge, supervising the clinical Quality Improvement staff conducting UR and ensure findings and recommendations are adopted by the treatment programs.
Lead NYS OMH licensing audits in collaboration with senior directors and coordinate post-audit corrective action plans and the continuous review of performance.
Demonstrate a commitment to diversity, equity, and inclusion through continuous development, modeling inclusive behaviors, and proactively managing bias and develop the equity standards for the Quality Improvement team.
Coordinate and deliver staff training in standards of care, client privacy, treatment planning, documentation standards for medical necessity, person-centered, culturally responsive, and trauma-informed care that progressively seeks to reduce health disparities and achieves health equity.
Manage and oversee the team of quality assurance specialists and act as escalation point person for organizational Quality Improvement practice and activities.
Identify opportunities for Quality Improvement (QI) and in collaboration with program, data & analytics, and evaluation staff, lead QI workgroups and develop plans and strategies to improve services and client outcomes; and for the licensed programs report to the trustee Governing Body and executive leadership on status of compliance and QI.
Coordinate QI projects with the Coordinated Behavioral Care Independent Practice Association and Health Home (CBC) and develop population-based health disparity QI initiatives (including racial/ethnic groups, and sexual and gender minorities), using
