Project Renewal's Health Homes Program is seeking a full time experienced Quality Assurance Specialist to join a small data/quality assurance unit within the Health Homes Department. The Quality Assurance Specialist monitors the services delivered by the Care Coordination program. We are looking for an organized, detailed, and assertive individual. The ideal candidate should have extensive knowledge of NYS Office of Mental Health regulations, NYS Department of Health regulations, Medicaid and Medicare, and Managed Care Organizations. Previous experience with the NYS Health Homes program is a plus. This position requires expertise in standards of care related to assessment, treatment planning, risk assessment and risk management, incident reporting, information sharing and confidentiality, utilization review, continuous quality improvement, consumer rights and consumer satisfaction.
Quality assurance activities for the care coordination program Conduct regular and systematic review of the initial assessments, psychiatric evaluations, progress notes, treatment plans and treatment plan reviews, care coordination services, and primary care integration services to ensure documentation is timely and has expected quality Conduct utilization review Assess discharge procedures and discharge documentation Monitor services delivered to high risk participants and individuals identified for the primary care integration registry Develop reports of findings and recommendations and communicate to supervisory staff Track, monitor, and measure the annual quality performance of the program and develop recommendations based on annual changes Identify staff training needs through auditing activities Monitor and track the implementation of corrective action plans Collect incident reports, conduct trending analysis and support operations of Incident Review Committee Conduct review of records for 'high risk' consumers to ensure risk assessment and risk management protocols adhere to policies Support the Care Coordination directors and supervisors through data tracking to support continuous quality assurance initiatives and projects Analyze program data and maintain data related to implementation of evidence-based practices and clinical outcomes Support clinical directors and supervisors to create systems and processes that facilitate achievement of quality assurance goals and continuous quality improvement Adhere to cultural competency and anti-discriminatory practice and other duties as required by the Director and Associate Director of Health Homes
At least one year of quality assurance experience preferred; Effective interpersonal skills and ability to successfully use authority to work with staff throughout the agency; Experience with electronic health records (EHR); Bilingual in Spanish preferred.
Bachelors in Healthcare Administration, Public Health, Business or other related healthcare field or the equivalent work experience required.
Minimum of one year quality improvement experience in a health plan or health care setting required. Demonstrated leadership experience preferred. Excellent oral, written and interpersonal communication skills, including group facilitation skills required. Knowledge of basic performance improvement tools and methodologies preferred.
To apply: e-mail resume and cover letter indicating position and salary requirements to: firstname.lastname@example.org EOE