Quality Assurance Program Manager II
Quality Assurance Program Manager II
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Job Description
The Richmond Behavioral Health Authority is seeking a Quality Assurance Program Manager II to join our SUD & Primary Health Care Services Team. This position will performs complex administrative work related to planning organizing directing and coordinating the quality activities/functions of staff; providing guidance and/or developing logical processes to implement quality improvement actions that ensure required documentation in medical records are in compliance with laws regulatory HIPAA and Authority standards; training program staff on all personcentered documentation; coordinating/ developing improvement strategies for measuring analyzing and reporting on the efficiency productivity and clinical soundness of the delivery of Substance Use Disorders (SUD) and Primary Health Care services; reviewing records to ensure clinical soundness and best practices are being utilized to ensure clients needs are met; performs other related work as needed or assigned. Work is performed under the general direction of the Director of Adult Substance Use Disorder Services.
Essential Functions
Provides clinical and administrative supervision of staff assists with the recruitment and selection of program staff; assigns directs trains and inspects the work of staff; disciplines coaches counsels and evaluates staff performance; recommends suspensions termination promotion and demotion; develops staff schedules.
Assists and provides ongoing training in SUD Division including electronic health record system and Authority/regulatory/documentation and reimbursement standards.
Reviews and monitors documentation for compliance with Authority/regulatory/reimbursement/best practice standards and medical necessity admission/discharge/transfer eligibility and readiness and to ensure compliance with Licensure Department of Medical Assistance Services (DMAS) regulations and Authority standards.
Provides training to address findings from quality reviews to enhance best practices clinical soundness effective interventions regulatory compliance and personcentered components per licensure (DBHDS) DMAS and Authority standards.
Prepares and distributes reports including cost estimates and outlining activity including narrative and statistical summaries.
Summarizes review findings for submission to supervisory staff; prepares reports or provides requested information as needed.
Assists with SUD Divisions program evaluation and strategic planning processes to improve and address barriers to quality service delivery.
Assists with developing/monitoring implementation of short and longrange plans for SUD & Primary Health Care services quality assurance services delivery and systems integration.
Coordinates and troubleshoots electronic and health record documentation in the electronic billing interface for the delivery of SUD and Primary Care services Division with Finance/Reimbursement and Administration.
Identifies problems; evaluates pertinent factors; develops/implements logical solutions.
Develops presentations training documents and communication related to quality services.
Develops and maintains data systems and internal processes for monitoring overall quality of services.
Required Experience:
Manager
Employment Type
Full-Time
