Quality Improvement Specialist- CCBHC Macari

The Child Center of NY • New York, NY

23h • Hybrid

About The Position

The Quality Assurance/Improvement Specialist is responsible for developing, monitoring, and implementing strategic quality improvement processes in the Behavioral Health Division. The Quality Improvement Specialist works with program directors and staff to assure the performance and quality of care and services for the persons and families served by The Child Center of NY.

Requirements

• Masters Degree and LQHP- LMSW, LMHC, LMFT with clinical experience.
• Prior experience with Medicaid funded program.
• Prior knowledge of Medicaid and HIPAA regulations.
• Ability to work independently on multiple tasks while meeting deadlines.
• Comfort level with large data sets, statistics and billing information.
• Excellent communication skills, both written and verbal with good public speaking and presentation skills.
• High level of skill with MS Office software including Word, Excel, Outlook and knowledge of management information systems. Willingness and ability to learn new systems.

Responsibilities

• Maintain up-to-date knowledge of the program, licensing body, government and accreditation regulations to ensure compliance, communicating and addressing any changes as they may occur. This includes researching and advising on regulatory compliance questions, as needed.
• Independently develop processes and procedures to ensure quality client services and compliance with professional standards.
• Conduct, document and track QA functions including, but not limited to: Utilization/Chart Reviews to ensure compliance with all regulations identify patterns/trends of challenges, and follow through on corrective actions; Billing reviews ensuring all Medicaid billing is supported by accurate documentation; Submission of routine summaries with all findings, QI plans and associated data.
• Maintain and ensure compliance with client and agency confidentiality standards and ethical expectations.
• Collaborate on a routine basis with program leadership to develop and review standardized tracking and reporting for Incident and Chart reviews, compliance and best practice gaps, analyzing findings to develop quality improvement plans, monitor implementation of such plans, and provide training/coaching when necessary.
• Ensure Communication with program staff about performance and quality of care/services within the level of complexity that program staff are able to understand, using discretion as per his/her expertise in understanding and interpreting quality and performance data and with support from leaders with additional expertise when necessary.
• Advise senior management on issues such as program performance and quality matters by making educated and intellectual interpretations and summaries of quality and performance data.
• Develop in-house expertise in the various electronic management systems used by assigned programs for data review, reporting, and billing purposes. Address/train program staff in these systems.
• Perform other related duties as assigned.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level