Quality Assurance Coordinator - Madras, OR

BestCare Treatment Services in Madras is recruiting for a Quality Assurance Coordinator position! This is a Full Time regular position that includes employer-paid health benefits, FOUR WEEKS of paid time off, NINE recognized holidays, and a retirement account.

General Duties: The role of the Quality Assurance Coordinator is to review client charts to ensure compliance with Medicaid rules; and to develop, organize, coordinate, and implement the quality management program for BestCare Treatment Services. The Quality Assurance Coordinator works closely under the supervision of the Program Director, as well as closely with the clinical supervisors of mental health and alcohol/drug programs to address quality issues, file/documentation issues, provide in-house training to clinical teams, and help them improve their clinical documentation and the delivery of treatment services.

Specific Duties:

  • Develops, organizes, coordinates, and implements the quality management program for BestCare Treatment Services in collaboration with the Program Director and other agencies or organizations when directed.
  • Develops and implements the annual Quality Improvement Work Plan. Identifies, develops and implements quality assurance projects through analysis of data; develops performance improvement projects working collaboratively with the Program Director, Quality Management Committee, Clinical Supervisors, and clinicians.
  • Coordinates the delivery system compliance monitoring program. Conducts reviews of client files, in both mental health and alcohol/drug treatment. Develops protocols and procedures related to site reviews. Organizes and documents findings, preparing comprehensive reports. Identifies problem areas, possible solutions and impacts, and recommends appropriate corrective actions. Performs on-going monitoring and documentation of clinician compliance with regulatory requirements. Provides technical support to administrative and clinical staff related to quality and performance improvement activities.
  • Works collaboratively with Program Director and Clinical Supervisors to identify and develop quality improvement Performance Indicators, to guide change and improve outcomes.
  • Maintains on-going and routine internal audits of client charts to ensure compliance with Medicaid regulations. Develops protocols and procedures for auditing processes and functions.
  • Gathers and analyzes data from a variety of databases and sources. Conducts research related to quality improvement. Creates reports and presentations for advisory councils as requested by the Program Director.
  • Reviews Oregon Revised Statutes, Oregon Administrative Rules, and the Oregon State Integrated Service and Support Rules/ISSR, trains staff, and assists management to monitors for internal compliance.
  • Assists the Program Director to review informal complaints and formal grievances submitted by enrolled members, and critical incident reports. Assists under direction with the resolution of complaints and grievances consistent with practices and principles of clinical risk management. Tracks incident reporting and performs analysis of trends.

Minimum Requirements:
Experience coordinating and performing quality assurance or quality improvement activities in health care settings, preferably in behavioral health. Must be able to gather and analyze data, prepare reports, develop programs and protocols which maximize the delivery of high-quality services to our members, and provide technical assistance to our program staff. Must be able to handle multiple priorities while remaining composed, and able to see the larger picture beyond the details. Graduate degree in Mental Health, Public Health, Public Administration, or Health Care Administration helpful. A pre-employment, post-offer background check will be conducted for this position.

Specific Qualifications for Position:

  • Thorough knowledge of principles and practices of health administration, quality assurance, and performance improvement.
  • Knowledge of the Oregon Health Plan Medicaid program.
  • Ability to interpret and apply rules, regulations, policies, procedures, and contract requirements as they relate to this behavioral health program and the MHO.
  • Ability to analyze issues and problems from multiple perspectives, identify solutions and recommend appropriate action.
  • Knowledge of organizational processes and design, and administrative techniques.
  • Knowledge of quantitative and qualitative analysis and statistical research methods, techniques, and procedures.
  • Experience preparing comprehensive report and presentations.
  • Ability to plan and conduct audits, evaluate program compliance and recommend improvements in operations.
  • Ability to document processes and procedures and keep workflows functioning over extended periods of time.
  • Ability to communicate effectively, both orally and in writing.
  • Ability to work on concurrent tasks in a fast-paced environment while effectively prioritizing and coordinating work assignments.
  • Experience in using a variety of computer software applications.

Tool and Equipment Used:
Computer, printer, telephone, power point machine, fax machine.

Physical Demands:
The physical demands described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing this job, the employee is regularly required to reach with hands and arms. The employee is frequently required to stand, walk, and use hands to handle, feel, or operate objects or controls. The employee is occasionally required to sit; climb or balance; stoop, kneel, crouch, or crawl; and talk and hear. The employee must occasionally lift and/or move up to twenty (20) pounds. Specific vision abilities required by this job include close vision and the ability to adjust and focus. The position also includes the ability to operate a motor vehicle.

Work Environment:
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The position requires the employee to dress in a professional manner that meets the standards for professional employees in Jefferson County (casual but neat and clean).

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