Details: Competitive salary
123 William Street
- Conduct or participate in reviews and analyses of quality-of-care-related data and program performance data to determine progress toward CBC and external regulatory provider goals and objectives;
- Participate in design and delivery of workshops and other materials downstream providers and care coordination agencies that provide knowledge and information on accrediting, regulatory and professional standards and practices that pertain to evidence-based service delivery and quality of care for existing and new programs;
- Chair CBC's Health Home Quality Management Team; CBC’s Children’s Quality Management Team;
- Participate in meetings with network agencies to establish, delineate, and review policies, to coordinate functions and operations between agencies and stakeholders, and establish responsibilities and procedures for attaining objectives and assist with the implementation of new programs;
- Draft quality assurance policies and procedures;
- Report to program directors for oversight of special investigations and projects, member complaints and non-conformance issues;
- Participate in reviews of clinical information system and program evaluation-related technical problems and procedures and recommends solutions or changes in procedures;
- Devise sampling procedures and directions for recording and reporting statistical quality data;
- Consult with network agencies to develop and execute quality improvement plans, including Corrective Action Plans (CAPs) to be developed;
- Supports documentation of internal and external audits, site visits and other quality assurance activities;
- Supports ongoing compliance with quality and regulatory requirements;
- Evaluate adequacy of quality and regulatory requirements;
- Attends outside meetings on behalf of CBC;
- Performs other related duties, as assigned.
- Knowledge of mental illness, mental health legislation and regulations, and health conditions.
- Advance knowledge of Microsoft office applications, including Excel.
- Ability to manage multiple projects and ask for help when needed.
- Ability to manage resources, which includes material, time, and people.
- Ability to participate on a team to accomplish tasks.
- Serves as a role model to staff and stakeholders.
- ·Ensure that internal and external regulatory agency standards and requirements are met.
- ·Analyze and evaluate aggregate data to identify trends and opportunities for project/pilot innovations.
- College-level problem solving ability.
- Basic knowledge of techniques for identifying and preventing crises, including crisis management techniques.
- Ability to communicate and work effectively with all stakeholders, and with due understanding of and consideration for cultural differences.
- Strong customer service skills and the ability to analyze data to resolve provider and insurance service issues.
- Competency in written, interpersonal, verbal and computational skills to present and document records and reports in accordance with program standards.
Comprehensive benefits package.
Level of Language Proficiency
Education and Experience
- A Master’s Degree in Social Work, Nursing, Public Health, Public Policy or a related field.
- Minimum of five (5) to seven (7) years of experience in working with the Behavioral Health population in quality assurance activities, UR/UM.
- Significant familiarity with non-profit organization management. Work well in a fast-paced environment; treat others with respect and consideration; accept responsibility for own actions. Understand business implications of decisions, align work with strategic goals, complete administrative tasks and develop strategies to achieve organizational goals.
- Superior solution-focused communication and writing skills.
- Experience serving or developing systems who serve persons with chronic health conditions, behavioral health conditions, persons experiencing homelessness, and persons with Medicaid
Minimum Education Required