Quality Improvement Coordinator

PROMESA R.H.C.F.•New York, NY

3d•$0 - $70,000

About The Position

The Quality Improvement Coordinator works under the supervision and direction of the Corporate Compliance Officer to analyze clinical documentation and review administrative and compliance requirements for behavioral health programs. The coordinator reports audit findings and potential deficiencies to leadership and helps develop corrective action plans to evaluate procedures and services as required by OASAS, OMH, and other regulatory agencies. The role ensures documentation quality and accuracy, monitors performance trends, maintains current knowledge of healthcare regulations affecting reimbursement and quality outcomes, and communicates risks and improvement recommendations to management. The coordinator also facilitates quality assurance and improvement projects and supports better patient experiences and clinical outcomes.

Requirements

Associate degree in Social Work, Psychology, Public Health, Registered Health Information Administration, or a related field.
At least one year of experience in a mental health, primary care, or substance abuse setting.
Knowledge of OMH, OASAS, and Health Homes concepts and processes.
Strong interpersonal and verbal communication skills, with the ability to engage staff at all levels.
Collaborative team-player skills.
Ability to work with a team of professionals in a culturally diverse environment.
Ability to multitask and function under pressure.
Proficient knowledge of medical terminology, ICD-10, and CPT codes.
Knowledge of Medicaid and other federal and state compliance guidelines.

Nice To Haves

Undergraduate degree in Social Work, Psychology, Public Health, Registered Health Information Administration, or a related field.
Two years of experience in project coordination, audit readiness, and/or care management.
A track record of success in audits, chart reviews, and incident management.

Responsibilities

Conduct concurrent reviews of OASAS and OMH medical records for completeness, compliance, and consistency with clinical documentation and federal and state regulations.
Promote evidence-based practices by leading behavioral health electronic record reviews, PDSA cycles, and performance improvement projects.
Provide management with constructive recommendations based on audit findings.
Ensure audits are complete, accurate, and documented on time.
Facilitate monthly continuous quality improvement meetings with programs; monitor and analyze behavioral health documentation through program-specific chart audits; and document audit reports and summaries.
Modify business processes to measure patient outcomes and satisfaction, including through the Patient Satisfaction Survey (Perception of Care survey).
Develop and monitor systems for HIPAA compliance and research state regulations and compliance guidelines.
Establish compliance tracking systems that meet legislative and accrediting organization deadlines, including trend identification and root cause analysis.
Provide routine, scheduled, and ad hoc audit reports, including trend identification and root cause analysis of treatment plans, progress notes, and identified problems.
Coach and provide feedback to staff as part of quality assurance training.