Job Details
Level
Experienced
Job Location
CFBHN Corporate Office – Tampa, FL
Remote Type
N/A
Position Type
Full Time
Education Level
Graduate Degree
Salary Range
$53,166.00 – $59,166.00
Travel Percentage
Up to 50%
Job Shift
Day
Job Category
Nonprofit – Social Services
Description
Position Summary: The Quality Specialist II works with the CQI and Risk Management team to coordinate quality improvement, contract compliance and service validation initiatives monitored by CFBHN.
Essential Job Functions
- Participates in the process of monitoring Network Service Providers (NSPs) to assess contract/financial compliance, validate service documentation and billing, and best practice. Ensures compliance with contractual requirements, CARF accreditation standards, HIPAA laws, and Florida state statutes that govern behavioral health services and CFBHN operations.
- Serves as primary point of contact for an assigned caseload of subcontracted organizations. Responds to questions and maintains contact with NSPs throughout the CQI monitoring process.
- Completes monitoring reports to summarize results and findings. Conducts Action Plan follow-ups as required and within required timeframes.
- Reviews and interprets data, as necessary, to assist in identifying trends and issues in need of NSP attention.
- Provides training and technical assistance to subcontracted providers, as required, to bring them into compliance with CQI requirements.
- Communicates monitoring results to other CFBHN departments. Ensures that information in CFBHN data systems is accurate and edited or backed out as necessary.
- Represents the CQI department on the Critical Incident Review Committee. Conducts case file reviews as assigned by CQI Manager. Writes reports to identify observations and/or other issues in need of NSP attention or correction.
- Maintains knowledge of Substance Abuse, Mental Health, and Block Grant programs coordinated by CFBHN.
- Participates in CQI Department meetings, to include CQI Oversight, Board and Network CQI Committees.
- Working with the CQI team, develops, updates and revises tools utilized as part of the monitoring process.
- Leads and/or participates in additional projects as assigned.
- This position is predominantly remote with partial onsite as needed.
Qualifications
Required Education/Experience
- Master’s degree in behavioral health field with two years of experience in providing quality oversight for the provision of behavioral health services, or an equivalent combination of education and experience.
Required Knowledge, Skills & Abilities
Position Specific
- Above-average knowledge of the principles and practices of collaborative quality improvement/quality assurance
- In-depth understanding of system of care principles and values
- Knowledge of federal and state regulations related to the provision of behavioral health services
General
- Ability to manage multiple tasks and prioritize to meet deadlines
- Knowledge of Microsoft Office suite as applicable to the position
- Ability to travel as required by the position
- This position is predominantly remote with partial onsite as needed