Under the supervision of the Senior Quality Administrator, the Quality Improvement Coordinator is responsible for performing comprehensive analyses of clinical documentation, review of key administrative and compliance requirements, as well as informs the leadership team of audit findings, potential deficiencies and assists in the development of corrective action plans to evaluate procedures and services performed as required by OASAS and any other regulatory agency for behavioral health programs. In addition, this role is responsible for ensuring quality of documentation, performance trends with a high degree of accuracy and quality, maintaining current knowledge of healthcare regulatory guidelines that impact reimbursement and quality outcomes and communicates with up-line management of identified trends and areas of risk to provide recommendations for improvement in the patient experience and clinical outcomes. Under the direction of the Administrator, the Quality coordinator facilitates quality assurance and improvement projects. Skills and competencies required for the position include planning, organization, analytical problem solving, and leadership skills. The salary is $32.00/Hour
KEY ESSENTIAL FUNCTIONS:
- Concurrent reviews of OASAS medical records to validate completeness, compliance, and consistency with clinical documentation in accordance with federal and state regulations.
- Assess compliance of services provided to residential clients.
- Champion Evidence Based Practices by leading behavioral health electronic record review, PDSA's and performance improvement projects.
- Provides constructive recommendations to management as determined by audit findings.
- Ensure audits are complete, accurate, and documented timely.
- Facilitate monthly continue Quality Improvement (CQI) meetings with program staff.
- Monitor and analyze behavioral health documentation (monthly program specific chart audits). Document quality assurance audit reports/summaries.
- Modify business processes to measure client outcomes and satisfaction as driven by client satisfaction surveys (Perception of Care survey).
- Develop and monitor systems to ensure compliance with (Health Insurance Portability and Accountability Act).
- Research state regulations and compliance guidelines.
- Establish compliance tracking systems with timeliness as mandated by applicable legislative and accrediting organizations, including trend identification and root cause analysis
- Provides routine/scheduled and ad hoc audit reports, including trend identification and root cause analysis (treatment plan and progress note-reviews/problem identification).
- Provides coaching and feedback to staff as part of quality assurance training.
- Associates degree in Social Work, Psychology, Public Health, Registered Health Information Administration or related field required.
- Undergraduate degree in Social Work, Psychology, Public Health, Registered Health Information Administration or related field preferred.
- Two (2) years' experience in project coordination, audit readiness and/or care management preferred.
- Minimum of 1-year experience working in a mental health, Primary care or substance abuse setting required
- Knowledge of OASAS concepts and processes required.
- Track record of success in audits, chart reviews, and incident management preferred
- Strong interpersonal and verbal communication skills, ability to engage staff at all levels;
- Collaborative team player.
- Ability to work with a strong team of professionals in a culturally diverse environment.
- Ability to multitask and to work and function under pressure.
- Proficient knowledge of medical terminology, ICD-10 and CPT codes
- Knowledge of Medicaid and other federal/state compliance guidelines