Quality Specialist II

Come Put your Experience to Use and Work with Great People! Central Florida’s Behavioral Health Network, Inc. (CFBHN) is one of the leading behavioral health managing entities in the state of Florida, covering 14 counties. Contracted with the Department of Children and Family, we provide oversight to providers in central Florida who serve in the mental health and substance abuse field in all types of settings, including school and community settings. We have been in business for more than 25 years, are well respected in the field, and are located in a convenient location near Brandon just off the Selman Expressway, not far from downtown! Quality Specialist II works with the CQI and Risk Management team to coordinate quality improvement, contract compliance, and service validation initiatives monitored by CFBHN. One of the best things about working at CFBHN is that the company truly cares about its employees, and it shows in the length of time our employees stay with us. Many of our staff have been here ten years or more. We offer a great paid time off program that includes paid vacation days, paid sick days, paid personal days, and a paid volunteer day! Our health and dental benefits are 100% employer paid for telehealth. We offer a great 401k plan along with a profit‑sharing plan to help you prepare for your future. This is a great hybrid role which is mostly work from home. We provide your laptop, cell phone, monitor, and other supplies you may need. Responsibilities Essential Job Functions Participates in the process of monitoring Network Service Providers (NSPs) to assess contract/financial compliance, validate service documentation and billing, and best practice. Ensures compliance with contractual requirements, CARF accreditation standards, HIPAA laws, and Florida state statutes that govern behavioral health services and CFBHN operations. Serves as primary point of contact for an assigned caseload of subcontracted organizations. Responds to questions and maintains contact with NSPs throughout the CQI monitoring process. Completes monitoring reports to summarize results and findings. Conducts Action Plan follow‑ups as required and within required timeframes. Reviews and interprets data, as necessary, to assist in identifying trends and issues in need of NSP attention. Provides training and technical assistance to subcontracted providers, as required, to bring them into compliance with CQI requirements. Communicates monitoring results to other CFBHN departments. Ensures that information in CFBHN data systems is accurate and edited or backed out as necessary. Represents the CQI department on the Critical Incident Review Committee. Conducts case file reviews assigned by CQI Manager. Writes reports to identify observations and/or other issues in need of NSP attention or correction. Maintains knowledge of Substance Abuse, Mental Health, and Block Grant programs coordinated by CFBHN. Participates in CQI Department meetings, to include CQI Oversight, Board and Network CQI Committees. Working with the CQI team, develops, updates and revises tools utilized as part of the monitoring process. Leads and/or participate in additional projects as assigned. Qualifications Required Education/Experience Master’s degree in behavioral health field with two years of experience in providing quality oversight for the provision of behavioral health services, or an equivalent combination of education and experience. Knowledge of Microsoft Office suits the position. Ability to travel as required by the position. Above‑average knowledge of the principles and practices of collaborative quality improvement/quality assurance. In‑depth understanding of system of care principles and values. Knowledge of federal and state regulations related to the provision of behavioral health services. Ability to manage multiple tasks and prioritize meeting deadlines. We Offer Health & dental (100% paid for employee) Vision benefits (deeply discounted pricing) Hybrid role – Predominately work from home Life Insurance ($10,000 policy, 100% paid) 401k (after 90 days) Profit sharing (after six months) AD&D policy (100% employer paid) Telehealth at no cost AFLAC available 12 paid vacation days, 12 paid sick days Two paid personal days and one paid volunteer day Nine paid holidays Employee assistance program And more great benefits! Send your resume now! #J-18808-Ljbffr Central Florida Behavioral Health Network (CFBHN)