Quality & Compliance Specialist | $500 Sign On Bonus

Quality Management Specialist

Under the direction of the Quality & Compliance Manager, the Quality & Compliance Specialist is part of the Quality Management/QM Department and assists in ensuring that high-quality clinical services are delivered while maintaining compliance with regulating and contracting entities.

Ensures the accurate and timely collection of data from clinical records, identifies opportunities for improvement and areas of non-compliance. Communicates and works collaboratively with the QM Department team, residential program leadership and agency QM Committee members.

Primary Duties and Responsibilities

• Provide data entry of QM data into the quality database.
• Develops forms and protocols within the QM Department to gather real time clinical record information.
• Aid in the creation and development of various clinical data reports and perform data entry.
• Audit clinical record data on a regular basis to ensure data integrity, quality, identify data anomalies, and enter results into databases.
• Aggregate audit data received, identifying all documentation weaknesses and risk trends, as they present, that have potential to impact licensing, regulatory or contractual compliance
• Identify and report data entry errors and omissions immediately to Director of QM.
• Ensure clinical record confidentiality and HIPAA compliance
• Track clinical record documentation and audit results submitted by Quality Assurance Specialists.
• Collect, compile, and analyze data from the QM team to measure and report on provider and program clinical record documentation and other record related performance.
• Provide data and other related materials for clinical audits for compliance reporting and internal data tracking/agency evaluation needs
• Create monthly reports for the Director of Quality Management and quarterly reports for the Quality Management Committee.
• Train and update program management staff quarterly on data collection activities.
• Other duties as assigned.
• Promote agency mission, purpose, and values in relationships with internal and external partners.

Minimum Qualifications

• Bachelor of Science with two years' experience preferred, Four years of experience may be substituted for the educational requirement.
• Experience in health information technology and strong computer skills required.
• Experience in data collection and assessment.
• Good analytical and organizational skills
• Familiar with electronic medical records systems/EMRS (ie: Avatar/EPIC) and Microsoft Office platform.
• Knowledgeable about California Mental Health Medi-Cal residential and Specialty Mental Health-Outpatient billable services and documentation including, diagnosis and medical necessity justification is preferred.
• Knowledgeable about California Drug Medi-Cal residential substance use disorder billable services and documentation, including ASAM criteria and levels of care designation, diagnosis and medical necessity justification is preferred
• MH and Drug Medi-Cal audit experience via EMRS or hard copy chart.
• Willingness to work non-traditional hours as the job necessitates
• Must maintain annual TB clearance and First Aid /CPR Certification.

• Exhibit exemplary customer service, compassion, and care in the execution of all duties and interactions.

Salary and Benefits:

This is a full-time, non-exempt position. PRC Baker Places offers a competitive salary plus medical, dental, and vision insurance for employees and their eligible spouse/children, as well as short/long-term disability, life insurance, employer-matching contributions to 403(b) retirement, generous paid time-off, and professional development.