Quality Management Analyst
Under limited supervision, evaluates and recommends improvements for the quality of behavioral health services provided by CODAC and its subcontracted service providers. This position also oversees all on-going activities related to the development, implementation, maintenance of, and adherence to the agency’s policies and procedures, covering the privacy of, and access to, patient health information in compliance with federal and state laws and healthcare organizations’ information privacy practices and utilizing in-depth knowledge of quality management practices.
Essential Duties and Responsibilities:
- Monitors and evaluates the overall quality of behavioral health services provided by CODAC and its subcontracted service providers to ensure compliance with health plans, state legislation, CARF accreditation standards, and AHCCCS and ADHS/DBHS and other regulatory requirements.
- Performs periodic chart reviews, quality improvement monitors and focus reviews and prepares reports of findings and recommendations for corrective action implementation.
- Tracks, monitors and implements improvement actions for specialized projects and evaluates the success of such actions.
- Investigates critical incidents, Notice of Concerns, and Quality of Care Concerns and prepare reports/responses of findings.
- Monitors and facilitates the responses for Grievances and Appeals.
- Provides training and technical assistance to agency staff and subcontracted providers.
- Serves as QM liaison to departments, committees and work groups within CODAC.
- Monitors agency sites for compliance with regulatory requirements and reports results to applicable sites and internal committees.
- Assists with agency-wide preparation process in maintaining national accreditation status.
- Coordination and/or processing of correspondence to other agencies, staff and clients in accordance with policies and procedures related to confidentiality.
- Coordination, preparation and assistance with internal and external audits
- Perform and report on assigned record reviews.
- Assist in annual process of writing, reviewing and updating policies and procedures.
- Oversee and monitor the receipt and execution of subpoenas/court orders while assuring legality of releases of information, and protection of health information. (HIPAA)
- Performs other related duties in accordance with agency growth and changes.
Skills / Requirements
Position Requirements: Pre-employment Competencies/requirements
Education and/or Experience: A combination of one of the following education and work experience are required:
- Bachelor's degree in a behavioral health field AND
- At least 2 years of Behavioral Health experience.
- Certified Professional Coder, preferred
- Valid Arizona Driver’s license, proof of current insurance and willingness to use personal vehicle.
- Motor Vehicle Record - no more than 2 moving violations or a license suspension in past 3 years.
- Extensive knowledge of Systems of Care.
- Extensive knowledge of community resources.
- Extensive knowledge of behavioral health challenges which include knowledge of the impacts of mental illness, domestic violence, and the dynamics of addictive behavior.
- Intermediate to advanced computer skills using MS Office products, Word, Excel, Access, etc., importing/exporting data to/from applications.
- Knowledge of advanced statistical methodologies.
This position is part-time 10 to 20 hours per week.