Quality Management Specialist Team Leader
4 weeks ago
The Quality Management Specialist Team Leader will assist in the daily operation of the Provider Monitoring processes. This entails tracking, trending, and resolving significant incidents and quality concerns. The ideal candidate will have a Master's degree in behavioral health, healthcare, or social sciences, and at least 3 years of post-graduate experience in a healthcare or quality management setting.
Key Responsibilities:
- Assist in tracking and trending of all reported quality issues and produce trend analysis.
- Investigate clinical quality issues and complete all required reports and related documentation.
- Conduct on-site provider visits, monitor Quality Improvement Plan submissions, and prepare required letters to providers.
- Assist with coding of all Significant Incident Reports and determining level of follow-up warranted.
- Assist with coding of all Quality Concerns.
- Complete Credentialing Committee Report.
- Complete weekly Bed Refusal report.
- Complete weekly OMHSAS Mortality Report.
- Complete bi-weekly Naloxone report.
- Provide coverage for provider meetings and site visits.
- Complete monthly provider licensure review.
- Complete provider profiles as requested.
- Provide support to new Quality Management Specialist during onboarding process.
- Master's degree in behavioral health, healthcare, or social sciences.
- Minimum of 3 years of post-graduate experience in a healthcare or quality management setting.
- Proficient in Microsoft Office applications.
- Excellent written and verbal communication skills.
- Knowledge of PA Act 68, Appendix H, and medical necessity criteria.
- Customer service skills.
- Training and facilitating skills.
- Strong interpersonal skills.
- Thorough knowledge of DBH and DHS systems and services.
- The successful candidate must be a current Philadelphia resident or become a resident within six months of hire.
- CBH does not provide sponsorship for applicants requiring future work authorization. All candidates must be legally authorized to work in the United States without requiring sponsorship now or in the future.
- CBH is an equal opportunity employer and does not discriminate in recruiting, hiring, promotion, or any other personnel action based on all qualified individuals. This is without regard to race, ethnicity, creed, color, religion, national origin, age, sex/gender, marital status, gender identity, sexual orientation, gender identity or expression, disability, protected veteran status, genetic information, or any other characteristic protected by applicable federal, state, or local law.
- CBH is committed to providing equal employment opportunities for individuals with disabilities or religious observance, including reasonable accommodation when needed.
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