Quality Management Director

PRIMARY FUNCTIONS

Under the supervision of the VP of IHHS, the Quality Management Director assists in providing effective operations and improvement of quality management services, including agency-wide performance improvement, regulatory compliance, individual case analysis, and oversees the Quality Management committee.

SPECIALIZATIONS

None

MINIMUM QUALIFICATIONS

To perform this job successfully, an individual must be able to perform each essential duty. The requirements listed below are representative of the knowledge, skill, and or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions

1. Masters Degree in appropriate healthcare-related field with 3-5 years experience in managed care and quality management at a supervisory level with increasing responsibility. Masters Degree in healthcare related field preferred.
2. Must have a working knowledge of Quality Management processes including audits, performance improvement plans and root cause analysis.
3. Requires excellent leadership skills and an ability to interact well across departments, facilities, and organizations.
4. Excellent organizational, human relations and communication skills are required to maintain good rapport and effective working relationships with internal and external customers.
5. A working knowledge of risk management, regulatory programs, and data management and analysis is required.
6. Knowledge and understanding of general mental health, substance abuse, co-occurring disorders, and serious mental illness.
7. Possess a valid Drivers license and ability to be insured under automobile insurance policy.
8. Able to work a flexible schedule as needed program requirements
9. Have excellent typing/computer skills and experience with various software (Excel, Word, PowerPoint, etc.) as well as electronic medical record systems.
10. Have excellent verbal and written communication skills.
11. Have good organization and time management skills
12. Ability to obtain fingerprint clearance card, CPR and First Aid.

JOB RESPONSIBILITIES AND COMPETENCIES

1. Administration / Management
2. Assists in assuring the provision of accurate and reliable data acquisition and analysis to support program, clinical and administrative decision-making.
3. Manages internal audit process, including coordination of root cause analysis, process improvement, tracking/trending, and reporting of results and data.
4. Assure that clinical records are accurate, current and meet Arizona Health Care Cost Containment System (AHCCCS) standards and Arizona Department of Health Services (ADHS) licensure regulations. This includes conducting the following: chart audits, review of documentation, staff training and other activities to assure quality of care standards are met.
5. Coordinates outside program audits with regulatory agencies and completes Corrective Action Plans in coordination with Program Directors as needed.
6. Assists in the coordination of activities to assure compliance with regulatory requirements. This includes both internal and external reporting.
7. Participates in the development and implementation of Quality Management Services goals and objectives and process improvements, corrective action plans and root cause analysis. Develop and revise program policies and procedures, as needed and/or at minimum of annually.
8. Facilitate monthly IHHS Quality Improvement Committee and IHHS Safety Committee meetings.
9. Participate in internal and external committees and management team meetings as needed.
10. Facilitates the accreditation process for all behavioral health programs through the Commission on the Accreditation of Rehabilitation Facilities (CARF) and ensures ongoing programmatic compliance with all CARF requirements.
11. Assures that staff and clinic productivity is maintained to meet contractual requirements. Provides ad hoc reports to program supervisors as needed.
12. Manages staff training program through the online Relias Learning System and provides training to staff on compliance matters as needed.
13. Completes credentialing activities for practitioners and facilities with health plans, AHCCCS and Medicare.
14. Communicates with Human Resources on personnel issues involving clinical, intern students and administrative staff
15. Tracks and completes program licensures and renewals with the Arizona Department of Health Services (ADHS).
16. Performs all functions according to established policies, procedures, regulatory and accreditation requirements, as well as applicable professional standards.
17. Other duties as required.

LANGUAGE SKILLS:

Effective oral and written communication skills, including; ability to read and comprehend technical instructions, short correspondence, memos, business correspondence and mental health related documents, ability to write clear, concise and accurate correspondence. Capable of establishing positive interpersonal relationships with a broad range of people.

OTHER SKILLS REQUIRED:

Ability to operate a personal computer with Microsoft Office software, printer, copy and fax machines, and other office equipment.

JOB DEMANDS

Ability to travel statewide as needed. Ability to communicate clearly and effectively both verbally and in writing. Able to present operational information to personnel at all levels.

PHYSICAL DEMANDS:

The physical demands described here are representative of those that must be met by staff member to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of the job, the employee is regularly required to sit, stand, move up and down stairways, talk and hear, drive to and from community appointments.

The employee must regularly lift and/or move up to ten pounds and occasionally lift and/or move up to twenty pounds. Specific vision abilities required by this job include close vision, distance vision, and peripheral vision.

MENTAL DEMANDS:

Ability to solve practical problems and deal with a variety of concrete variables in situations where standardization may or may not exist. Ability to reason effectively and interpret a variety of instructions furnished in written, oral or diagram form. Ability to synthesize new information and mentor individuals.

This position requires the individual to work with minimal supervision. Guidance is available as necessary, however, the individual is expected to be able to function autonomously and make individual decisions when appropriate. Position does require ability to interact with a variety of individuals and the ability to meet deadlines and time pressure based on the volume of work.

CONTINUOUS EDUCATION

Employee will be expected to participate in continuous learning, competency building and maintenance of competency skills.

TYPICAL WORKING CONDITIONS

Work is performed in structured environments.

ACCOUNTABILITY

Reports to and is supervised directly by the Vice President of IHHS or Designee. Employee is also accountable for understanding and complying with CPLC policies and procedures, area of practice ethics and professional conduct.