Employee Job Description
Position: Director of Quality Management
Reports to: Executive Director
FLSA status: Exempt
Position Summary: The Quality Management Director will provide leadership and oversight over Quality Assurance & Quality Improvement responsibilities and tasks across the agency. The Director of Quality Management will ensure that client services meet the agency’s expectations, licensing requirements regarding service quality and outcomes.
Qualifications: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. 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.
- Master’s Degree and 2+ years of relevant management experience (CA Clinical License as LCSW, MFT, LPCC, PhD preferred)
- Possess a high level of integrity, honesty and strong work ethic, with ability to maintain a professional demeanor in a stressful environment
Ability to effectively communicate (orally and written communication) and respond to inquiries or complaints from co-workers, program staff, clients, customers, and representatives of other organizations, regulatory agencies or departments.
- Basic knowledge and understanding of Medi-Cal Mental Health Services, regulations, requirements and billing systems. Willingness and ability to be the agency expert regarding Medi-Cal regulations and the policies/procedures of each of our contract counties
- Knowledge of principles, application and standards of practice of health care laws and regulations, information privacy/security laws, access, release of information and release control technologies (including HIPAA and HITECH ACT)
- Knowledge of principles and methods for practices of project planning, system analysis, monitoring, problem solving, implementation and evaluating, development and evaluation
- Excellent organizational, prioritization and management skills, with a strong attention to detail and time management
- Skilled at using initiative and independent judgment within general policy guidelines
- Obtain and maintain fingerprint and government and Agency required background clearances
- Valid California driver’s license with an acceptable driving record and auto insurance showing as an insured driver
- Possess and agree to continue to work on cultural competency and humility
- Proficient in using Microsoft Word, Microsoft Excel, internet, email and databases is essential
Essential Functions and Responsibilities
- Act as a liaison, advocate between the agency and contracting counties regarding all quality assurance tasks including, but not limited to contract objectives, documentation standards, compliance issues including regulatory, fiscal, operational and other county requirement. Attend relevant County and regional meetings
- Supervise Quality Management Staff
- Oversee, plan, implement and actively guide internal utilization, clinical and peer reviews, CQRT & PURQC chart audits, medication monitoring, facilitate quality assurance reviews and produce summary reports and feedback for managers that identify issues, plans of correction and follow-up regarding accuracy, completion, timeliness, quality, with regulatory compliance and internal protocols
- Provide support and guidance to the Director of Mental Health, for focused review as it relates to mental health activities
- Provide periodic reports to Senior Management on all QM processes for each program
- Work closely with Agency managers in developing and recommending program policies which meet federal, state, and local government requirements. Provide lead direction to clinical and nursing staff regarding quality assurance programs and expected outcomes
- Serve on the agency’s Continuous Quality Maintenance and Improvement Oversight Committee and oversee CQMI activities
- Develop long lasting systems for maintaining databases that ensure easy access to reports requested by Program Directors and external agencies
- Oversee the process for new and closed charts including tracking, printing, filing, and storage
- Provide support to direct service staff in the efforts to complete charts by specified deadlines and to meet Medi-Cal standards
- Ensure compliance with HIPAA requirements for privacy/security practices
- Assist in billing procedures for mental health programs
- Work with County Staff to obtain staff IDs and inform managers of changes in county policy and procedures
- Monitor Medi-Cal status for all clients enrolled in the program
- Responsible for training new staff on office policies and protocols related to quality assurance and improvement and manage paperwork related to required training
- Assist in development, evaluation and maintenance of outcome data for the agency including, but limited to the following :
- Examination of aggregate data on outcomes
- Identification of potential problem and/or patterns of outliers
- Prepare an annual report on agency and county required outcomes
- Plan for, oversee and respond to any request for review by external stakeholders such as a County or State or Federal Agency
- Assist with contract renewal processes and updating program materials
- Prepare and implement the Quality Improvement Work Plan and Performance Improvement Projects
- Plan and implement multi-faceted training for Agency employees and contract providers and plan and implement any other County mandated training and develop procedures for evaluating agency trainings
- Participate in the planning and implementation of a compliant Electronic Health Record and billing system
- Assume other duties as assigned by supervisor
Physical Demands and Work Environment
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Physical demands: While performing the duties of this job, the employee is consistently required to talk or hear. The employee frequently is required to drive, stand, walk, sit; use hands to finger, handle or feel objects, tools, or controls, and reach with hands and arms; repetitive motion with hands using a keyboard and mouse. The employee is occasionally required to climb, balance, stoop, kneel, crouch, crawl or walk on uneven, wet or slippery surfaces. The employee must occasionally lift and/or move up to 30 Specific vision abilities required by this job include close vision, distance vision, peripheral vision, depth perception, and the ability to adjust focus. The employee must be able to adhere to the Agency’s attendance and punctuality policy. Employee must be able to travel to AFS offices and/or County meetings using a non-agency owned vehicle in safe working order
- Work environment: Noise level is considered moderate.
The statements herein are intended to describe the general nature and level of work being performed by employees and are not to be construed as an exhaustive list of responsibilities, duties, and skills required of employees so classified. Furthermore, they do not establish a contract for employment and are subject change at the discretion of the Agency.
CAL-PEP’s Mission Statement
CAL-PEP’s overall mission is to provide accessible health education, disease prevention, risk reduction, and support services to people at high risk for HIV/AIDS in a culturally and linguistically appropriate manner. Through these services it is CAL-PEP’s goal to empower African Americans and other disenfranchised people to live healthy and productive lives.
EQUAL EMPLOYMENT OPPORTUNITY STATEMENT
CAL-PEP is an Equal Opportunity employer. We actively seek applications from people living with HIV/AIDS, and other disabilities, women, gay men, lesbians, transgender and people of color.