Reporting to the Director of Quality Management, the Quality Management Coordinator is responsible for managing the functions of quality assurance/quality improvement, data collection and reporting, and monitoring the utilization management for each program. Leads and ensures adherence & compliance with CARF and county contracts, takes the lead in partnership with the QM Director to support new program implementation, and assists with the monitoring of clinical services to assure minimum quality standards and continuous quality improvement.
Takes in lead role in partnership with
Program Directors and the Quality Management Director for external audits, responds to DHCS & county Audits and
Correction Action Plans, Participates and facilitates in the absence of Quality
Assurance Clinicians/Specialist the monthly QI/H&S meetings for programs,
identifies program compliances needs and works to close gaps, assists in
pulling grant data, attends county meetings, assists with policy and procedure
updates, Supports QA Clinicians to submit county reports, ensures the Medi-Cal
trackers are weekly, provides EHR and
clinical documentation training, and reviews the Census Reports.
DUTIES AND RESPONSIBILITIES
lead, document, and facilitate QR related meetings (QI, QRSUR, Health &
patient records to be audited for QRSUR
for ensuring auditing of 10% of the QRSUR patient records.
staff on using the auditing tool for peer audits as needed
staff on chart documentation updates and improvements.
the QRSUR results and review final results with the QRSUR committee, present
audit trends at QIC monthly.
partnership with Quality Management Director, maintain up to date with CARF
standards to ensure that programs are adhering to the minimum requirements for
the quality of services provided compared to clinical best practice guidelines.
collaboration with the Director of Quality Management and Privacy Officer,
takes the lead to ensure the QA Clinicians/specialist complete the Quarterly QR
for collecting, tracking and auditing program's grievances to ensure timely
resolution of client complaints. Present grievance trends and areas of
improvement during monthly QIC meetings.
and monitors clinical and administrative processes to assure the quality of
care and regulatory compliance.
support with monitoring county data entry systems (i.e. AVATAR, IRIS, Sage,
etc.) to ensure timely entry of CalOMS, authorizations, appeals, etc.
county utilization review audits and support with responding to Corrective
and provides EHR (Welligent/Exym) specific training for staff
compliance with record-keeping standards, appropriateness of services provided,
and/or determines the need for additional services.
a variety of complex and independent activities involved in the collection,
analysis, documentation, and interpretation of data related to quality
improvement. Creates monthly reports and
quarterly reporting for QIC and as needed for grants or other reporting.
and interpret collected data and prepare written reports and analyses setting
forth progress, adverse trends, and appropriate recommendations or conclusions
to ensure continuous quality improvement.
with billing for the resolve of billing violations to ensure proper resolution.
regularly with multi-disciplinary team members concerning client and program
issues; assists in the development or modification of procedures for
improvement of services.
forms and procedures to track and compile information and apply appropriate
data analysis techniques to maintain tracking statistics.
partnership with the Quality Management Director, maintains liaison with other
provider agencies' Quality Assurance, Utilization Review, and Risk Management
offices as well as related administrative departments; represent Phoenix House
on various quality audit and review committees.
abreast of new developments in the field of Quality Assurance / Improvement as
related to mental health/SUD, recommend new policies, and revise existing
policies/procedures for compliance with all applicable laws and standards.
or participates in other projects as assigned.
assists in the preparation of grant proposals.
and recommends positions on policy/procedural/clinical issues, and proposals.
regarding case/issue specific clinical questions.
Phoenix House at meetings, training events, and conferences.
technical assistance and consultation to clinicians.
compliance with local, state, and federal confidentiality laws and regulations.
all required staff training sessions in accordance with Phoenix House and state
licensing requirements, completes all training on time
and participates in program and all staff meetings.
to and promotes the Phoenix House Mission, Vision, and Values while acting as a
role model for others.
records requests in the absence of Quality Assurance Clinicians/Specialist.
collaboration with the Director of Quality Management, takes the lead on collecting data and preparing the monthly QIC presentation
and conducts the QIC presentation in the absence of the Director of Quality
duties as assigned.
Quality Management Coordinator shall possess a
degree in a related field Required
- Three (3)
to Five (5) years administrative experience required
in Substance Abuse or Mental Health preferred
with DMC-ODS, CalAIM, SAPC, DMH, Community Care Licensing, and other governing
maintain a valid California Drivers' License, have proof of automobile
insurance and maintain a safe driving record based on Phoenix House policy
KNOWLEDGE, SKILLS, AND ABILITIES
- Demonstrated commitment and adherence
to Phoenix House Mission, Vision, and Values: I CARE For: Integrity,
Collaboration Appreciation, Respect, Excellence, and Forward-Thinking
Proficiency in MS Office systems
- Ability to utilize an electronic
- Experience and ability to collect and
analyze data for continuous improvement reporting.
- Experience with reporting and data
- Establish and maintain effective
working relationships with others
- Communicate effectively with others
both orally and in writing
- Ability to work effectively in a
fast-paced changing environment
- Ability to establish and consistently
enforce appropriate boundaries with patients
- Ability to model positive behavior and
- Understanding of addiction, co-occurring
models, and treatment modalities
- Understanding of patient development
and family systems
- General understanding of the
residential medical model of treatment, SUD treatment practices, group
facilitation utilizing Evidenced Based Treatments and continuing care practices
that lead to successful discharge transitions for all assigned patients
- Excellent time management and
- Strong crisis management, conflict
resolution, and de-escalation skills.
- Ability to be flexible; problem
solver, self-directed; customer service-oriented, and collaborative
Skills and ability to engage and develop a
rapport with patients and families of various backgrounds
Job Location: Lake View Terrace, CA
Job Number: 631