Quality Improvement/Compliance Specialist - Tucson, AZ (Bonita)

Community Partnership of Southern Arizona•Tucson, AZ

61d

About The Position

The Quality Improvement Specialist/Compliance Specialist serves in a dual-capacity role designed to support both the integrity of Implementation of performance and quality improvement strategies and medical record systems and across Intermountain Centers and its affiliated programs. This position ensures compliance with local, state, and federal regulations regarding documentation, privacy, and reporting requirements. The incumbent will also assist with audit readiness, data tracking, and quality analytics, serving as a bridge between frontline operations and compliance leadership. Performance will be evaluated against specific key indicators of success.

Requirements

Minimum Education Required: High School Diploma or Equivalent
Minimum Experience Required: Minimum of two (2) years in primary care, behavioral health, or healthcare compliance setting; direct experience with medical records systems, electronic health records (EHRs), and regulatory reporting.
Valid AZ DPS Level I fingerprint clearance card (must maintain valid card throughout employment)
Initial current negative TB test result, if required (Employer provides).
Minimum 18 years of age.

Nice To Haves

Preferred Education: Bachelor's degree in healthcare administration, public health, or data analytics preferred.

Responsibilities

Medical Records Management
Medical Documentation Processing: Receive, organize, scan, and upload medical documents into Electronic Health Records (EHR) systems. Ensure all entries are correctly named, categorized, and placed in the appropriate member files within 48 hours of receipt.
Records Requests and Releases: Manage all internal and external requests for medical records. Verify requests, obtain appropriate authorizations, and ensure timely and secure release in compliance with HIPAA, 42 CFR, and other applicable laws and organizational policies.
Records Maintenance and Retention: Ensure physical and digital records are stored, retained, and destroyed in accordance with federal and state regulations, as well as organizational policy. Coordinate offsite archiving and retrieval processes with third-party vendors like Iron Mountain.
System Proficiency and Documentation Accuracy: Maintain a high level of proficiency in all electronic medical records systems utilized by the organization. Conduct regular audits to ensure documentation accuracy, completeness, and proper classification.
Compliance Monitoring: Ensure the organization meets all regulatory requirements concerning PHI/PII, including developing and maintaining tracking logs for records requests, releases, and destruction logs.
Quality Improvement and Data Reporting
Contractual and Regulatory Reporting: Develop and oversee processes to ensure timely and accurate submission of quality reports in compliance with funder requirements (e.g., AHCCCS, DDD, DCS), accreditation standards, and internal benchmarks.
Data Analysis and Trend Reporting: Analyze quality and performance data to identify trends, service gaps, or compliance issues. Create written reports summarizing findings and offering recommendations for improvement.
Audit Coordination and Corrective Actions: Serve as point of contact for internal and external audits related to documentation and quality performance. Assist program sites in the preparation and monitoring of corrective action plans.
Process Improvement Support: Lead or assist in continuous quality improvement initiatives that improve outcomes, efficiency, or compliance. Provide insight into documentation improvement and system inefficiencies.
Staff Training and Support
Onboarding and Ongoing Training: Deliver training sessions to new and current staff on medical record-keeping, privacy/confidentiality requirements, data reporting procedures, and quality improvement processes.
Standard Operating Procedures (SOPs): Create and maintain comprehensive SOPs and process documentation for medical records management and quality improvement reporting.
Subject Matter Expert Consultation: Provide ongoing guidance to sites and staff on regulatory changes and best practices in documentation and performance tracking. Act as a resource for resolving compliance concerns.
Responsible for following any policies, procedures, and controls established by the organization, the HIPAA Privacy Officer, and/or the HIPAA Security Officer regarding access to, protection of, and the use of the PHI.
Maintains an approved schedule, and acceptable level of attendance.
Other duties as they relate to the general nature of the position.