Quality Assurance Coordinator-Mental Health
Under supervision, by the Clinical Director, this position is responsible for enhancing the accountability and performance of existing and planned mental health programs.
The QA Coordinator performs quality assurance reviews of the clinical records and j1 services of the CSB, including analysis and recommendations of improvements related to staff certifications, adherence to clinical accreditation, licensure, and Medicaid and other third-party payer standards in support of the provision of community mental health, substance use, and prevention services across a ten-county catchment area.
Work involves maintaining agency preparedness for the Department of Behavioral Health and Developmental Services j2 (DBHDS) Licensure and Human Rights Reviews, and analyzing matters pertaining to various clinical and administrative issues, reporting the findings, and recommending courses of action.
Duties also involves working collaboratively with clinical and administrative directors, state governing body and agencies.
The Quality Assurance Coordinator must have the ability to work independently, and to exercise considerable initiative and independent judgment in all phases of work.
Must display tact and courtesy in frequent contact with CSB staff, CSB Vendors and regulators, and staff from other agencies whose work is materially affected by the quality of CSB services.
Assists reviewing all requirements related to agency licensure, and/or certification, and/or evaluation, making recommendations to the Clinical Director and taking actions, to include conducting staff trainings necessary to ensure preparedness for such licensure, certification, and/or evaluation visits and reviews.
Assists reviewing all requirements related to agency reimbursement from all third-party payers, including Medicaid (DMAS, Virginia Department of Medical Assistance Services), making recommendations to the Clinical Director and taking actions necessary to ensure preparedness for such visits and reviews conducted by third-party payers or their agents.
Assist with developing, implementing, and managing internal evaluation system designed to ensure that all services are delivered in a manner that meets guidelines established by DBHDS, DMAS, contract Health Maintenance Organizations, other payers, other public regulatory agencies, other organizations charged with the certification and/or accreditation of the agency's programs and services.
Reviews and enters Human Rights complaints, including allegations of abuse, neglect and exploitation and Serious Incident Reports into the state database, conducts Root Cause Analyses of Incidents and conducts investigations as assigned by Executive Director.
Assist with developing policies and procedures in support of a quality management system.
To participate, as necessary or desirable, in regular meetings of the clinical and/or administrative staff of the clinical services divisions, and/or of the CSB's management team.
Assist with developing, implementing, conducting regular staff trainings for quality assurance topics like Human Rights, Confidentiality and Release of Records.
Maintains current records of the clinical competencies and certifications of staff, and to utilize the CSB's IT systems to integrate those records with those reports necessary for payers and regulators.
Assists with various short and long-term CSB projects, including annual and special reports, comprehensive state planning initiatives, demographic and disability-incidence statistical projections that may be related to the provision of quality services.
Job QualificationsEducationEducation/Equivalent Bachelor's degree in a human services field (Psychology, Social Work; Counseling, or Special Education), or combination of education and work experience that provides the equivalent.
ExperienceA minimum of five (5) years of clinical services experience in a community setting in the provision of mental health, and/or substance abuse services; seven (7) or more years preferred.
A minimum of two (2) years of supervisory experience in a public agency; three (3) or more years preferred.
Familiarity with DBHDS Licensing and Medicaid Utilization Review guidelines; experience in coordinating quality assurance procedures.
Additional KnowledgeDBHDS Licensure Regulations and Interpretive Guidelines;Medicaid Utilization Criteria;Managed Care standards and guidelines;Applicable Federal, State, and Local regulations;Methods of quality assurance, outcome measurements, and program evaluation;State Human Rights Policies and Procedures;Federal and State requirements for the confidentiality of client records;Computer operations, software, and MIS systemsBenefits include:
Anthem BCBS Health insurance including dental & visionRetirement through the Virginia Retirement System (VRS)Life InsuranceStaff development and in-service training12
paid holidaysPTO accrued at 8 hours first 6 months, increases to 16 hours per month (equals 4.
8 weeks per year)Verizon Wireless discount of 15% on service plansThe agency of MPNN Community Services Board maintains a drug free workplace.
For all positions at MPNN CSB,candidates must be fully vaccinated against COVID-19 and present acceptable proof of vaccination by the date of hire as a condition of employment.
MPNN CSB will consider requests for reasonable accommodations required under applicable law.
To qualify as being fully vaccinated againstCOVID-19there should be a two week period after receiving the second dose (or any government recommended booster shot)in a 2-dose COVID-19 vaccine series, or a two week period after receiving a single-dose (or any government recommended booster shot) in a single dose COVID-19 vaccine.
EOE.
Estimated Salary: $20 to $28 per hour based on qualifications.
The QA Coordinator performs quality assurance reviews of the clinical records and j1 services of the CSB, including analysis and recommendations of improvements related to staff certifications, adherence to clinical accreditation, licensure, and Medicaid and other third-party payer standards in support of the provision of community mental health, substance use, and prevention services across a ten-county catchment area.
Work involves maintaining agency preparedness for the Department of Behavioral Health and Developmental Services j2 (DBHDS) Licensure and Human Rights Reviews, and analyzing matters pertaining to various clinical and administrative issues, reporting the findings, and recommending courses of action.
Duties also involves working collaboratively with clinical and administrative directors, state governing body and agencies.
The Quality Assurance Coordinator must have the ability to work independently, and to exercise considerable initiative and independent judgment in all phases of work.
Must display tact and courtesy in frequent contact with CSB staff, CSB Vendors and regulators, and staff from other agencies whose work is materially affected by the quality of CSB services.
Assists reviewing all requirements related to agency licensure, and/or certification, and/or evaluation, making recommendations to the Clinical Director and taking actions, to include conducting staff trainings necessary to ensure preparedness for such licensure, certification, and/or evaluation visits and reviews.
Assists reviewing all requirements related to agency reimbursement from all third-party payers, including Medicaid (DMAS, Virginia Department of Medical Assistance Services), making recommendations to the Clinical Director and taking actions necessary to ensure preparedness for such visits and reviews conducted by third-party payers or their agents.
Assist with developing, implementing, and managing internal evaluation system designed to ensure that all services are delivered in a manner that meets guidelines established by DBHDS, DMAS, contract Health Maintenance Organizations, other payers, other public regulatory agencies, other organizations charged with the certification and/or accreditation of the agency's programs and services.
Reviews and enters Human Rights complaints, including allegations of abuse, neglect and exploitation and Serious Incident Reports into the state database, conducts Root Cause Analyses of Incidents and conducts investigations as assigned by Executive Director.
Assist with developing policies and procedures in support of a quality management system.
To participate, as necessary or desirable, in regular meetings of the clinical and/or administrative staff of the clinical services divisions, and/or of the CSB's management team.
Assist with developing, implementing, conducting regular staff trainings for quality assurance topics like Human Rights, Confidentiality and Release of Records.
Maintains current records of the clinical competencies and certifications of staff, and to utilize the CSB's IT systems to integrate those records with those reports necessary for payers and regulators.
Assists with various short and long-term CSB projects, including annual and special reports, comprehensive state planning initiatives, demographic and disability-incidence statistical projections that may be related to the provision of quality services.
Job QualificationsEducationEducation/Equivalent Bachelor's degree in a human services field (Psychology, Social Work; Counseling, or Special Education), or combination of education and work experience that provides the equivalent.
ExperienceA minimum of five (5) years of clinical services experience in a community setting in the provision of mental health, and/or substance abuse services; seven (7) or more years preferred.
A minimum of two (2) years of supervisory experience in a public agency; three (3) or more years preferred.
Familiarity with DBHDS Licensing and Medicaid Utilization Review guidelines; experience in coordinating quality assurance procedures.
Additional KnowledgeDBHDS Licensure Regulations and Interpretive Guidelines;Medicaid Utilization Criteria;Managed Care standards and guidelines;Applicable Federal, State, and Local regulations;Methods of quality assurance, outcome measurements, and program evaluation;State Human Rights Policies and Procedures;Federal and State requirements for the confidentiality of client records;Computer operations, software, and MIS systemsBenefits include:
Anthem BCBS Health insurance including dental & visionRetirement through the Virginia Retirement System (VRS)Life InsuranceStaff development and in-service training12
paid holidaysPTO accrued at 8 hours first 6 months, increases to 16 hours per month (equals 4.
8 weeks per year)Verizon Wireless discount of 15% on service plansThe agency of MPNN Community Services Board maintains a drug free workplace.
For all positions at MPNN CSB,candidates must be fully vaccinated against COVID-19 and present acceptable proof of vaccination by the date of hire as a condition of employment.
MPNN CSB will consider requests for reasonable accommodations required under applicable law.
To qualify as being fully vaccinated againstCOVID-19there should be a two week period after receiving the second dose (or any government recommended booster shot)in a 2-dose COVID-19 vaccine series, or a two week period after receiving a single-dose (or any government recommended booster shot) in a single dose COVID-19 vaccine.
EOE.
Estimated Salary: $20 to $28 per hour based on qualifications.
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