H20 Quality Management Specialist

The H2O Quality Management (QM) Specialist supports day-to-day quality monitoring, compliance, and performance activities for Solari’s administration of the AHCCCS Housing and Health Opportunities (H2O) program. This position reviews provider performance, service documentation, data quality, utilization, billing and service trends, and other quality indicators; supports audits, corrective actions, reporting, and quality improvement initiatives; collaborates with providers and internal teams to address identified issues; and serves as a resource for routine quality matters while escalating significant trends, risks, and compliance concerns to the H2O QM Administrator. Responsibilities: H2O Quality Management & Compliance Conduct routine quality monitoring and reviews of H2O provider performance, service delivery, documentation, housing care plans, utilization, and other program requirements. Apply established quality monitoring tools, criteria, policies, and procedures to evaluate compliance with AHCCCS, H2O, contractual, and organizational standards. Document monitoring findings, identified deficiencies, required follow-up, and resolution activities. Track corrective action plans, remediation activities, and quality improvement commitments through completion. Support preparation for AHCCCS reviews, audits, and monitoring activities by gathering documentation, validating records, and tracking follow-up items. Identify and elevate significant, recurring, or systemic quality and compliance concerns to the H2O QM Administrator. Data Quality, Reporting & Performance Monitoring Review H2O data and documentation for accuracy, completeness, consistency, and timeliness. Identify missing, inconsistent, or potentially inaccurate information and coordinate with appropriate teams or providers to support correction. Department SDOH Division CSN Reports To H2o Quality Management Administrator Directly Supervises N/A FLSA Status Exempt Compile and monitor provider performance metrics, service utilization, housing outcomes, and quality indicators. Prepare routine quality and performance reports, summaries, trackers, and other monitoring materials. Analyze data and monitor results to identify trends, service gaps, recurring issues, and potential quality or compliance risks. Communicate findings and observations to the H2O QM Administrator and appropriate internal stakeholders. Provider Quality & Training Support Communicate routine quality monitoring findings, documentation concerns, and follow-up requirements to providers. Support Provider Support and the H2O QM Administrator in identifying provider education and technical assistance needs. Assist with development and delivery of training materials related to H2O requirements, documentation standards, billing expectations, housing care planning, and quality measures. Track provider corrective actions and performance improvement activities and report progress or unresolved concerns. Serve as a resource for routine provider questions related to quality expectations, monitoring processes, documentation requirements, and service delivery standards. Review claims, billing, reimbursement, and service authorization trends for potential quality, documentation, or compliance concerns. Research billing and claims-related discrepancies and coordinate with providers and internal teams to support resolution. Track recurring claims or billing issues and identify patterns that may affect provider performance, compliance, or member service delivery. Escalate systemic or unresolved claims and billing concerns to the H2O QM Administrator. Support development and maintenance of guidance, tools, and quality controls intended to reduce recurring billing and documentation issues. Program Administration & Team Coordination Maintain quality monitoring records, trackers, audit documentation, corrective action records, and other quality management materials. Support implementation and maintenance of quality management procedures, workflows, tools, and documentation standards. Participate in quality meetings, provider reviews, performance discussions, and cross-functional workgroups. Prepare meeting materials, quality summaries, findings, and follow-up documentation as assigned. Collaborate with Quality Management, Provider Support, Operations, Claims, Compliance, Business Analytics, and Evaluation & Impact teams to resolve quality concerns and support program objectives. Participate in continuous quality improvement initiatives focused on member outcomes, provider performance, compliance, service delivery, and program effectiveness. Other duties as assigned. Knowledge, Skills, Abilities: Knowledge of quality assurance, quality monitoring, compliance, auditing, and continuous improvement principles, along with healthcare, human services, housing, or publicly funded program operations. Ability to review documentation and data against established standards, identify discrepancies, trends, and areas of risk, and consistently apply policies, procedures, contractual requirements, and program guidance. Strong analytical, organizational, problem-solving, and communication skills, with attention to detail and the ability to maintain accurate records, analyze and communicate quality and performance information, manage multiple priorities, meet deadlines, and follow issues through resolution. Proficiency with Microsoft Office applications and the ability to learn and navigate HMIS, Electronic Health Record, claims, and other program systems. Ability to act professionally and maintains appropriate boundaries with clients and staff. Ability to report as scheduled to work, meetings, training, and job-related activities prepared and as scheduled. Ability to consistently demonstrate compassion and meet people with compassion; Effort, every interaction deserves my best effort; and Ownership, which drives the company's success. Maintains an open and accepting mindset by being an active learner, participating in discussions with others, trying new approaches and ideas, and being self-aware and self-reflective for continual personal, professional and leadership growth. Education & Experience: 2 years of experience in field, Required Bachelors Degree in Healthcare Administration, Public Administration, Social Work, Business Administration, Public Health, Data Analytics, Human Services, or related field, Required The candidate's applicable education and experience will determine where a candidate falls in the position range. Pay Range: $51,000 USD - $59,500 USD Working Conditions: While performing the job duties in the office or at a home office, the employee is frequently required to stand, walk, sit, and use hands; they must occasionally lift and/or move up to 25 pounds. Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus. Exposure to noise typical with office operations. Ability to hear and speak. Employees must maintain a stable and secure private home internet with a minimum of 50Mbps download and 5Mbps upload, and an average jitter less than 20% of latency. Who We Are & What We Offer: Solari is an award-winning nonprofit that operates a 24/7 crisis line serving statewide in Arizona, Oklahoma and Colorado. Our mission is to Inspire Hope through our talented and compassionate staff. Since 2007, Solari has been providing crisis contact center services and in that short time has helped thousands of individuals and families connect to the help they need. Additionally, in that short timeframe, Solari has grown to expand services to a peer-run Warm Line, Serious Mental Illness (SMI) determinations, mobile team dispatches, crisis transportation services, emergency room-based assessments, Department of Child Safety (DCS) rapid response and crisis stabilization services, telephone follow-up to those who need it, tragedy support lines and other in‑kind services to the community. Friendly work environment Generous paid time off (PTO) Health benefits (Medical/Dental/Vision) that start the first of the month following the hire date Competitive compensation Convenient office locations and Hybrid Schedule On-site fitness room free to all employees (Tempe Office) Basic Life Insurance Voluntary Life, Spouse, Child Insurance Critical Illness w/free dependents Critical Illness Spouse Short Term & Long Term Disability- Starts first of the month after 90 days of employment 401K & 401K Roth - Starts first of the month after 90 days of employment United Pet Care LifeLock for identity theft LYRA EAP Program- 25 free sessions for mental health per family member Solari is proud to be an equal opportunity employer and does not unlawfully discriminate against any employee or applicant for employee per applicable federal, state, and local laws. At Solari, a diverse mix of highly talented, innovative, and dedicated people cometogether to make a lifetime impact on each of our Client's lives. All qualified applicants will receive equal consideration for employment. We are focused on equality and believe deeply in diversity of race, color, ancestry, age, veteran status, marital status, creed, religion, sex, gender, gender identity, sexual orientation, ethnicity, national origin, and other legally protected group status. #J-18808-Ljbffr Solari, Inc.