Quality Improvement Specialist- CCBHC Macari

Child Center Residential Treatment Facility • Queens, NY

1d • Hybrid

About The Position

The Quality Assurance/Improvement Specialist is responsible for developing, monitoring,and implementing strategic quality improvement processes in the Behavioral HealthDivision. The Quality Improvement Specialist works with program directors and staff toassure the performance and quality of care and services for the persons and familiesserved 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 speakingand presentation skills.
• High level of skill with MS Office software including Word, Excel, Outlook andknowledge of management information systems.
• Willingness and ability to learn new systems.

Responsibilities

• Maintain up-to-date knowledge of the program, licensing body, government andaccreditation regulations to ensure compliance, communicating and addressing anychanges as they may occur. This includes researching and advising on regulatorycompliance questions, as needed.
• Independently develop processes and procedures to ensure quality client servicesand compliance with professional standards.
• Conduct, document and track QA functions including, but not limited to: Utilization/Chart Reviews to ensure compliance with all regulations identifypatterns/trends of challenges, and follow through on corrective actions; Billing reviews ensuring all Medicaid billing is supported by accuratedocumentation; Submission of routine summaries with all findings, QI plans and associateddata.
• Maintain and ensure compliance with client and agency confidentiality standards andethical expectations.
• Collaborate on a routine basis with program leadership to develop and reviewstandardized tracking and reporting for Incident and Chart reviews, compliance andbest practice gaps, analyzing findings to develop quality improvement plans, monitorimplementation of such plans, and provide training/coaching when necessary.
• Ensure Communication with program staff about performance and quality ofcare/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 andperformance data and with support from leaders with additional expertise whennecessary.
• Advise senior management on issues such as program performance and qualitymatters by making educated and intellectual interpretations and summaries of qualityand performance data.
• Develop in-house expertise in the various electronic management systems used byassigned programs for data review, reporting, and billing purposes. Address/trainprogram staff in these systems.
• Perform other related duties as assigned.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 251-500 employees