Quality Improvement and Compliance Analyst

Suncoast Center • St. Petersburg, FL

8h • Onsite

About The Position

The Quality Improvement and Compliance Analyst is responsible for completing clinical quality reviews to ensure adherence to quality standards, preparing reports, and communicating outcomes of quality reviews and activities. This role involves documenting and tracking internal audits and other quality assurance projects, participating in the internal Peer Review process, and analyzing summary reports to ensure programs meet standards across all quality indicators. The analyst will provide training to clinicians on areas needing improvement, ensure sustained improvement, and offer quality improvement suggestions on project protocols and processes, facilitating quality improvement plans in conjunction with the Manager. Key duties also include working with the Billing Department for adjustments, generating and interpreting utilization reports to make quality recommendations for client care, and independently gathering information from reviews. The position requires a thorough knowledge of all Agency programs and admission criteria to recommend appropriate levels of care and time frames. The working environment is an indoor office setting with frequent disruptions, exposure to multiple deadlines, auditing, and repetitive typing. The role demands the ability to deal with pressure, maintain accuracy, manage constantly changing situations, handle stressful situations and conflict, and work flexibly as part of a fast-paced team in an auditing/analyzing atmosphere while maintaining strict confidentiality.

Requirements

• Master’s degree in social services.
• Must be able to read and comprehend written instruction.
• Has mental health experience in a significant administrative or clinical position.
• Possess excellent computer skills and experience with Excel spreadsheets.
• At least one year experience in a mental healthcare environment with exposure to clinical review.
• Must be able to analyze complex issues and offer creative solutions.
• Must have strong communication skills.
• Strong orientation to client care in accordance with agency values.
• Must be 21 years of age.
• Negative Drug Screening prior to hire and throughout employment.
• Clear Criminal Background Check throughout employment with Suncoast Center and local checks prior to hire and annually along with DCF Level II prior to hire and as required by DCF.
• Must have valid Florida Driver’s License.
• Motor Vehicle checks prior to hire and annually with acceptable driving record maintained throughout employment along with reliable vehicle, valid registration, and valid vehicle insurance.
• Must be in compliance with Florida Laws and Administrative Codes with fingerprinting and determined to be of good moral character.
• Must have excellent computer skills and ability to work in the Agency electronic medical record and in Microsoft Word.
• Must be able to create and work in Excel, creating and updating spreadsheets in order to enter auditing results and summary reports to present to management and external organizations.
• The ability to function and operate as a team player, showing dignity and respect for all.
• The ability to comply with all equal employment opportunity and ethical standards and regulations.
• The ability to take direction in a respectful and productive manner from supervisors and managers.
• The ability to work, as scheduled, in a timely fashion, and with an attitude oriented to service.
• The ability to have cordial and professional relationships both within the organization and with vendors, clients and third parties.
• If appropriate, the ability to produce all appropriate paperwork and reports consistent with contractual, state or federal standard, and to prepare and submit such paperwork on a timely basis.
• The ability to understand and comply with Suncoast Center, Inc. policies and procedures.
• The ability to render compassionate care and equal commitment to serve clients in need of healthcare assistance.

Nice To Haves

• Florida State License preferred.

Responsibilities

• Completes clinical quality reviews to ensure adherence to quality standards.
• Prepares reports and communicates outcomes of quality reviews and activities.
• Documents and tracks internal audits and other quality assurance projects.
• Participates in the internal Peer Review process and analyzes summary reports to ensure programs meet standards across all quality indicators.
• Provides training to clinicians regarding areas in need of improvement.
• Ensures areas noted to have an opportunity for improvement are addressed and that improvement is sustained over time.
• Offers quality improvement suggestions on project protocols and processes; facilitates quality improvement plan in conjunction with Manager.
• Works in concert with the Billing Department and provides notification when adjustments to billing are required.
• Generates utilization reports and demonstrates the ability to interpret and analyze data in order make quality recommendations regarding client care.
• Works independently in gathering information from reviews and takes the initiative to seek information from members of the treatment team when needed.
• Has a thorough knowledge of all Agency programs and admission criteria and is able to recommend appropriate levels of care and time frames when appropriate.
• Adheres strictly to rules of discretion, tact and confidentiality.
• Assists leadership with project management and integration.
• Other duties as assigned.

Benefits

• Medical, dental, and vision insurance with 0 copy for Teledoc Appointments
• EAP Supports
• Company Paid Basic Life, Accidental Death and Dismemberment, and Long term Disability
• Options to secure additional Life/AD&D as well as short term disability
• Paid time off + 10 company paid holidays
• Professional development options through our Learning Management System and live trainings
• 403b with up to a 5% company match
• Monthly Social Committee Events

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 101-250 employees