Quality Assurance Coordinator

Options for Southern Oregon•Medford, OR

About The Position

The Quality Assurance (QA) Coordinator assists Options to maintain a Quality Assurance System, which meets the conditions of the Coordinated Care Organizations (CCOs), State Contracts and Medicaid/Medicare. The QA Coordinator is responsible for facilitating communication between the Quality Assurance Team, the Internal Quality Assurance Committee, Options Management and Staff and/or other parties to coordinate quality management activities including, but not limited to, utilization review, chart compliance audits, employee education activities including peer reviews, fidelity and programmatic consultation and reviews, and contract adherence. This position also provides high level care coordination for hospitalized individuals, including state level hospitalized individuals, to ensure that services are connected upon discharge. The QA Coordinator works collaboratively with Options staff to oversee the CCO QA metrics. This position may include managerial level duties for designated departments or other specified staff.

Requirements

Master’s degree in a behavioral health field or Registered Nurse (BSN required) or Occupational Therapist required.
Knowledge and understanding of the Medicaid system.
Understanding of challenges facing those receiving mental health services.
Must be a QMHP on the Mental Health & Addictions Certification Board of Oregon (MHACBO) registry.
OR
Meet eligibility qualifications to register with MHACBO (please visit www.mhacbo.org [http://www.mhacbo.org] for more information)
OR
Must be registered as a licensure intern with the State of Oregon or be licensed in Oregon as an LMFT, LCSW, LPC or clinical Psychologist.
In order to avoid potential conflict of interest, applicants for this position cannot have received services from Options for Southern Oregon within the last 12 months.
Candidates must be able to use e-mail, compose documents, save and locate documents electronically, and learn to use our Electronic Health Record (EHR) system. Possess business experience sufficient to meet the demands of the position, including demonstrated proficiency with a variety of software applications including MS Office, including Excel.
Must pass state-required background and DMV checks. Candidate must be able to work independently and flexibly, under general supervision.

Responsibilities

Works with the Chief Operations Officer and QA team to maintain a Quality Assurance Committee with Membership in alignment with CFRs, OARS and CCO Agreement standards.
Works with QA team and managers to follows annual compliance plan to ensure completion and that goals are met.
Raises system and compliance issues and follows until a resolution is complete. Maintains appropriate records of QA team activities and decisions.
Ensures that the CCO metrics are achieved. If necessary, provides the necessary mental health service to ensure metrics are met.
This position may be required to complete assessments and treatments plans (Children/Adults), meet clients in the community, and provide care coordination and transition planning for special cases.
Facilitates the development and adoption of standards (goals, objectives and benchmarks).
Coordinates the agency’s preparation efforts for reviews from oversight organizations.
Provides training and guidance to Options staff and subcontractors on Medicaid/Medicare compliance.
Works with electronic health record staff on workflows that meet compliance guidelines.
Provides assistance to fidelity or contracted programs as needed and may fill in to manage departments.
Provides complex care coordination between multiple agencies. Ensures care is established and set prior to hospital discharges.
Responds to occasional clients who present in the waiting room with a crisis.
Facilitates the development of annual QA Work plans, defining and assisting in the definition of the types of data needed to assess performance and identifying sources of data.
Coordinates reviews of agency sub-contractors, provides technical assistance and monitors compliance to contract.
Depending on needs of the program, may need to travel between sites or transport clients.
May assist in training and supervision of academic interns, including working with applicable schools and their systems
Licensed clinicians are required to register with their applicable board to assist in training and supervision of staff seeking certification/licensure.

Benefits

Family medical, dental, long term disability, 403(b) plan with 6% match, and more.
Generous paid time off policy. (Annual accrual up to 208 hours - based on FTE status and available to use upon accrual). Plus 11 paid holidays annually.

Stand Out From the Crowd

Upload your resume and get instant feedback on how well it matches this job.

Upload and Match Resume