Quality Reporting & Accreditation Specialist

Community Behavioral Health.•Philadelphia, PA

2d•$0 - $76,800

About The Position

The Quality Reporting and Accreditation Specialist serves as the primary project manager for CBH’s efforts to obtain and maintain National Committee for Quality Assurance (NCQA) Managed Behavioral Health Organization Accreditation, Certified Review Entity Certification, and HealthChoices Reporting. The specialist also assists the Director of Quality Improvement with monitoring, documenting, and reporting quality management activities. The role coordinates with accreditation and certification entities and the Office of Mental Health and Substance Abuse Services to support compliance with accreditation, certification, and HealthChoices requirements. It prepares CBH for submissions and reviews, develops tools to identify quality risks and mitigation opportunities, compiles information and maintains records for quality improvement, monitoring, accreditation, certification, and audits, and collaborates with internal departments on metrics and action plans. The specialist makes recommendations to CBH Officers and the Quality Improvement Committee, reports suspected provider or employee fraud, waste, or abuse, and coordinates communications about quality activities with internal and external stakeholders. The successful candidate must be a current Philadelphia resident or become one within six months of hire. Applicants must be legally authorized to work in the United States without requiring current or future sponsorship.

Requirements

Master’s degree in behavioral health, healthcare, public administration, or social sciences.
Certified Professional in Healthcare Quality (CPHQ) certification required within one year of hire.
Minimum of three years of 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.
Must be a current Philadelphia resident or become a resident within six months of hire.
Must be legally authorized to work in the United States without requiring sponsorship now or in the future.

Nice To Haves

Certified Professional in Healthcare Quality (CPHQ) certification (preferred, though required within one year of hire).
Project Management Professional (PMP) certification.

Responsibilities

Manage projects and coordinate with accreditation and certification entities and the Office of Mental Health and Substance Abuse Services to support compliance with accreditation, certification, and HealthChoices requirements.
Prepare CBH for accreditation, certification, and HealthChoices submissions and reviews.
Develop tools to assess exposure to quality risks and identify opportunities to manage and mitigate those risks.
Compile information for quality improvement and monitoring activities and accreditation or certification, for internal use and external audits, and maintain relevant records.
Collaborate with internal departments to develop metrics for program objectives and monitor action plans addressing compliance and quality improvement.
Recommend improvements or remediation to CBH Officers and the Quality Improvement Committee to ensure compliance with accreditation, certification, and HealthChoices requirements.
Support internal and external program integrity by identifying and reporting suspected provider or employee fraud, waste, or abuse.
Coordinate communications about quality improvement and monitoring activities with internal and external stakeholders.
Assist the Director of Quality Improvement in monitoring, documenting, and reporting quality management activities.