Quality Reporting & Accreditation Specialist

Community Behavioral Health.•Philadelphia, PA

36d

About The Position

The Quality Reporting and Accreditation Specialist will serve as the primary project manager for CBH’s effort to obtain and maintain National Committee for Quality Assurance (NCQA) accreditation Managed Behavioral Health Organization Accreditation, Certified Review Entity Certification, and HealthChoices Reporting. The Quality Reporting and Accreditation Specialist will also assist the Director of Quality Improvement in the monitoring, documenting, and reporting of quality management activities.

Requirements

Master’s degree in behavioral health, healthcare, public administration, or social sciences.
Certified Professional in Healthcare Quality (CPHQ) preferred; CPHQ Required within 1 year of hire;
Minimum of 3 years post-graduate experience.
Mid to high level proficiency with Microsoft Office applications
Excellent written and verbal communication skills
Knowledge of HealthChoices regulations and requirements
Knowledge of NCQA requirements
Detail-oriented and highly organized
Knowledge of quality management, assurance, and improvement principles
Ability to work effectively with all levels of staff
Ability to manage ongoing projects and prioritize appropriately to meet deadlines
The successful candidate must be a current Philadelphia resident or become a resident within six months of hire.
CBH does not provide sponsorship for applicants requiring future work authorization. All candidates must be legally authorized to work in the United States without requiring sponsorship now or in the future.

Nice To Haves

Project Management Professional (PMP) certification is preferred.

Responsibilities

Serves as project manager for coordinating and collaborating with accreditation and certification entities and the Office of Mental Health and Substance Abuse Services to ensure compliance with accreditation, certification, and HealthChoices requirements. Prepares CBH for accreditation, certification, and HealthChoices submissions and reviews.
Develops tools that assist in determining exposure to quality risks and identifies opportunities to manage and mitigate those risks.
Compiles information for quality improvement and monitoring activities, and accreditation/certification for internal use and external audits, and maintains relevant records.
Works with internal departments to develop metrics to accomplish program objectives and monitors action plans relating to improving compliance with accreditation/certification requirements and quality improvement activities.
Makes recommendations to CBH Officers and Quality Improvement Committee for improvements or remediation to ensure compliance to accreditation, certification, and HealthChoices requirements.
Assist in assuring both internal and external program integrity by being alert to and reporting suspected instances of provider and employee fraud, waste, or abuse.
Responsible for coordinating messaging of quality improvement and monitoring activities to internal and external stakeholders.