Quality Assurance Specialist

Position Summary: Serves as a Quality Assurance Specialist specializing in conducting chart reviews/internal audits, researching into industry standards for services provided by START, reporting metrics on incidents, and providing ongoing leadership training to clinical leadership. Preference will be given to Nurses, Nurse Practitioners and similar medical professionals with Quality Assurance Background,

Responsibilities for Operations:

• Conduct internal audits to certify that patient behavior health records meet corporate, payee, contract requirements, and state Medicaid requirements, including informed consent compliance
• Identify gaps, missing information, and areas of weakness in behavioral health records compliance and communicate with managers and service providers to correct deficiencies
• Deliver and/or coordinate, monitor and track staff training to ensure compliance with all START, licensing and accreditation standards for behavioral health counselors
• Respond to requests for records from state agencies for the purpose of quality monitoring and auditing
• Monitor and track incident reports involving behavior health counselors and prepare quarterly analysis
• Develop and monitor Behavioral Health Peer review
• Monitor the timeliness of documentation and paperwork through weekly QA reminders to behavioral health staff and managers
• Provides ongoing support to behavioral health staff regarding quality related issues
• Prepares charts for external auditors in collaboration with Borough Deputy Directors
• Consolidate and provide QA data and incident report logs monthly
• Assists in the maintenance of all behavior health outcome measures including data collection, consolidation, and reporting.
• Analyze Key Performance Indicators and recommend process improvements
• Conduct on-going chart audits and identify any deficiencies in standard of practice and participate in internal compliance reviews and state audits.
• Chair Incident Review Committees in absence of Compliance officer, document and maintain IRC minutes, and follow-ups on behalf of the committee on a monthly basis.
• Provide ongoing leadership and trainings to Clinical leadership (Clinical directors, Assistant clinical directors, behavioral health supervisors, senior counselors and as well as behavioral health staff members) to ensure compliance with all regulatory standards.
• Other duties as assigned.

Qualifications:

• Bachelor’s and/or master’s degree in Human Services Related Field, Psychology, Business, or Organization Development.
• Expert knowledge of state Medicaid and Medicare requirements for patient record compliance and stay apprised of any changes or updates to policies and procedures
• A minimum of five (5) years of demonstrated experience managing Quality Assurance responsibilities and maintaining functional oversight.
• Specialized training in employment law, compensation, organizational planning, organization development, employee relations, safety, training, and preventive labor relations, preferred.
• Knowledge of accreditation standards as well as all state and federal statutes and regulations relative to behavioral health services provided, and ensure all programing meets set standards and statutes
• Knowledge of internal and external policies and programs to anticipate executive management’s reactions and explain technically complex matters in understandable terms.
• Skill with written and oral communication techniques appropriate to develop and deliver briefings, status/staff reports, supervisory training, present facts, recommendations, instructions, etc.
• Skill in establishing and maintaining effective and cooperative work relationships with organizations and activities throughout the organization and private sector.
• Skillful in and ability to plan, organize and/or direct team efforts to persuade management officials to accept and implement recommendations.
• Understand state Medicaid and Medicare requirements for patient record compliance and stay apprised of any changes or updates to policies and procedures
• Excellent written and spoken communication skills.
• Outstanding interpersonal relationship building and employee coaching skills.
• Excellent computer skills in a Microsoft Windows environment.

Limitations and Disclaimer

The above job description is meant to describe the general nature and level of work being performed; it is not intended to be construed as an exhaustive list of all responsibilities, duties and skills required for the position.

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Benefits

• Vacation, personal, and sick leave
• Medical, dental, vision plans
• Pension & retirement plan
• Short & long-term disability
• Life insurance
• AFLAC
• Pet Insurance

Student Loan Forgiveness Programs

• Public Service Loan Forgiveness
• National Health Service Corp Loan Repayment