Quality Assurance Specialist

Position Overview:

The Quality Management Specialist is responsible for assisting in the daily operation of the Quality Management processes. This entails tracking, trending and resolving significant incidents and quality concerns.

Essential Functions:

• Assists in the tracking and trending of all reported quality issues and produces trend analysis.
• Investigates clinical quality issues and completes all required reports and related documentation.
• Facilitates provider teaming meetings. Conducts on-site provider visits, monitors Quality Improvement Plan submissions, and prepares required letters to providers.
• Assist with coding of all Significant Incident Reports and determining level of follow up warranted.

Position Requirements:

• Education: Master's degree in behavioral health, healthcare or social sciences
• License/Certification: N/A
• Relevant Work Experience: Minimum of 3 years of post-graduate experience with at least 2 years of experience in a health care or quality management setting
• Proof of COVID19 Vaccination required
• Skills:
• Proficient in Microsoft Office applications
• Excellent written and verbal communication skills
• Must have 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

Equal Employment Opportunity: Community Behavioral Health (CBH) provides equal employment opportunities to all qualified individuals without regard to race, creed, color, religion, national origin, age, sex, marital status, gender identity, sexual orientation, individual genetic information or non-disqualifying physical or mental handicap or disability in each aspect of the human resources function.

Americans with Disabilities Act: Applicants as well as employers who are or become disabled must be able to perform the essential job functions either unaided or with reasonable accommodation. The organization shall determine reasonable accommodation on a case-by-case in accordance with applicable law.

This job profile reflects management's assignment of current duties, responsibilities, and essential functions; it does not prescribe all or restrict the tasks that may be assigned now, or in the future, relevant to the responsibilities for this position. Community Behavioral Health (CBH) may change the specific job duties with or without prior notice based on the needs of the organization.