Home » Careers » Quality Improvement Coordinator
Job Title:Total Quality Improvement Coordinator
Department:Compliance /Quality Improvement
Immediate Supervisor Title:Chief Compliance Officer (CCO)
Job Supervisory Responsibilities:Intermediate
General Summary:An exempt position responsible for directing and coordinating quality management efforts, including development, implementation, education, data collection, and analysis.
Essential Job Responsibilities
- Help the Quality Improvement Director (QID) and/or the corporate Chief Compliance Officer (CCO) to plan, design, implement, and maintain a comprehensive psychotherapeutic, clinical, and medical necessity practice continuous quality improvement (CQI) program, including utilization management and risk management.
- Assisted in educating new staff about QI systems and requirements, including providing training related to quality improvement and assurance processes and procedures.
- Meet with internal and external audiences to identify and problem-solve QI issues.
- Monitor everyday operations to ensure compliance with internal and external QI standards. Review records and other documentation to ensure service excellence.
- Helps to prepare annual QI report.
- Coordinate the effort to gather data and prepare reports to meet internal and external standards, as well as regulatory/accrediting guidelines, including client/consumer satisfaction data.
- Evaluate variance and other data to identify QI opportunities and risk management issues.
- Monitor utilization and service quality through medical necessity review, HEDIS quality measures, payer/provider/client satisfaction surveys, grievances/complaints resolution, and investigations.
- Follow through on complaints, including identification of corrective actions needed. Provide reports on results.
- Manage a team of auditor(s) and incident coordinator/investigator(s) under the oversight of the QID and or the CCO. Prepare, record, keep, track, and submit an incident report(s) internally and externally to the regulatory agencies when needed. Perform grievance/complaint intakes to consumers/clients.
- Provide EMR support and guidance to staff.
EDUCATION
Minimum of a Bachelor’s degree in Social Work or any health-related field or equivalent
Experience
Minimum four years of experience in behavioral and mental health with a minimum of three years of experience in quality management/leadership, preferably in a Core Services Agency (CSA) setting.
OTHER REQUIREMENTS:Current CPR certificate. NCQA certification preferred.
Performance Requirements
KNOWLEDGE
- Knowledge of CQI principles, practices, methods, and tools.
- Knowledge of computer applications related to QI, including spreadsheets.
- Knowledge of medical records and clinical care processes.
- Knowledge of medical necessity standards and DBH guidelines.
Skills
- Skill in effective education and facilitation of CQI efforts in the behavioral and mental health field
- Skill in the application of analytical methods and statistical software by developing appropriate reports.
- Skill in conducting QI checks of medical necessity documentation/records and other clinical documentation, including performing client satisfaction surveys.
Abilities
- Ability to educate staff in both verbal and written form about QI in formal and informal settings.
- Ability to interact effectively with healthcare team members.
- Ability to analyze QI data and identify trends and corrective actions.
Equipment Operated: Standard office equipment, including computer hardware and software.
Work Environment: Primarily office and classroom settings.
