Quality Management Specialist I/II

Salary : $76,960.00 - $104,291.20 Annually

Location : San Andreas, CA

Job Type : Full Time Regular - Benefited

Job Number : 2024-00103

Department : Health & Human Services Agency

Division : HHSA - Mental Health

Opening Date : 01 / 08 / 2025

Closing Date : Continuous

Position Description

Quality Management Specialist I : $37.00 - $45.47

Quality Management Specialist II : $40.79 - $50.14

Are you passionate about enhancing the quality of care in Health and Human Services, with a focus on Behavioral Health Services? We are seeking a dedicated Quality Management Specialist to join the Quality Management Team in the ongoing development, evaluation, and monitoring of our quality assurance and utilization review programs. In this vital role, you will collaborate with diverse teams, utilizing your curiosity and attention to detail to drive meaningful improvements.

Your independent judgment will be key in prioritizing and coordinating departmental activities, ensuring compliance with quality assurance standards. Additionally, you'll have the opportunity to bring data alive, transforming insights into actionable strategies that elevate the quality of our services. If you're ready to make a significant impact in the field of behavioral health, we'd love to hear from you!

Under general direction of the HHSA Director or designee, this position will be responsible for the development, evaluation and monitoring of quality assurance and utilization review programs for Behavioral Health Services. Incumbents use considerable independent judgment in prioritization and coordination of department activities for Quality Assurance compliance.

Example of Duties

The following duties are typical for this classification. Incumbents may not perform all of the listed duties and / or may be required to perform additional or different duties from those set forth below to address business needs and changing business practices.

• Audits medical records for compliance with Federal, State and Program standards.
• Implements and monitors service quality in accordance with state or federal standards, laws, regulations, and policies.
• Provides training for staff and contract providers on updated quality assurance requirements.
• Gathers data, prepares reports, conducts studies and research on utilization review and quality assurance.
• Maintains documentation of complaints and grievances.
• Reports outcomes and other data to State as required by contract, law or regulations.
• Monitors compliance with response timelines for access, treatment authorization requests and payment.
• Develops, updates and monitors the cultural competency plan.
• Monitors progress and develops reports required by the annual Quality Management Work plan.
• Implements utilization review and quality assurance reviews; coordinates Quality Improvement Committee.
• Serves on local and state committees or task forces.
• Monitor agreements and contracts with providers as assigned.
• Initiate, develop and revise written policies and procedures for quality management and compliance programs.
• Plan and oversee regular and periodic audits and internal reviews of operations.
• Work closely with managers in developing program policies which meet federal, state, and local government requirements.
• Attend relevant state and regional meetings.

Minimum Qualifications

Knowledge of :

Mental health and Substance Use methods for intervention and treatment; Legislation and laws which regulate the operations of public behavioral health programs at the local level; operations of mental health services at the state and local level; principles and practices of program planning and evaluation, needs assessment, and research methodology; community resources and service agencies, social and economic problems which call for the use of public and private services; principles and practices of casework methodologies; quality review / quality assessment principles, practices, methods and techniques; Federal, state and County regulations and policies pertaining to utilization review; cultural, socio-economic and language factors that affect service delivery to ethnic populations.

Ability to :

Plan, organize and coordinate program development and planning function; Develop and monitor performance standards; Develop and evaluate operational policies and procedures; Analyze problems and complaints and identify solutions; Prepare and interpret a variety of narrative and statistical data and reports; Communicate orally and in writing on a variety of issues; Understand, interpret and apply procedures, laws, rules and regulations as they apply to assigned area; Ensure compliance with federal, state and local guidelines, policies, rules and regulations; Develop and maintain harmonious relationships with employees, public officials, community groups, other agencies and the general public; review and interpret healthcare documentation; ascertain facts through examination of records; collect, interpret and evaluate data; interpret complex regulations, laws and guidelines, formulate policies and procedures; prepare concise, logical oral and written reports and explain policies, procedures and recommendations; communicate effectively both orally and in writing; prepare and maintain accurate records.

EDUCATION AND EXPERIENCE :

Quality Management Specialist I

A Baccalaureate degree from an accredited college and a minimum of four years' experience in an outpatient behavioral health setting, preferably with two years in a planning or administrative capacity.

Quality Management Specialist II

Licensure in California as a Licensed Clinical Social Worker (LCSW), Marriage and Family therapist (MFT), or related California license is required.

Special Requirements

Possession of a valid California driver's license.

Service Employees International Union Local 1021

For available Health / Dental / Vision insurance please visit the County Please note that Extra-hire positions that are benefitted, are only offered our CORE medical plan and are not offered dental or vision.

Program Highlights :

For more information, vists

Boot Allowance : $150 or $175 per year and is distributed once a year, in the first full pay period in the month of December. Qualifying Classifications : Registered EH Specialists, EH Techs, OSS Engineers, Fleet Manager, Junior Engineer, Mechanic series, Sheriff's Mechanic, Public Works Inspector, Road Maintenance Worker series, Integrated Waste Worker series, AG Techs, and AG Biologists, and Recycling Program Coordinator I / II, Permit Tech I / II, Engineering Tech I / II assigned to the Rock Creek Landfill facility, and Air Pollution Control Tech.

Uniform Allowance : $600 per calendar year split into monthly payments. Payments will be made monthly on the second pay check. Qualifying classifications : Custodian series, facility maintenance worker series, facilities maintenance engineer.

Extra-Hire :

Extra-hire employees are not eligible for step advances, vacation, seniority rights, holiday pay or other certain employee benefits. They are entitled to 24 hours of sick leave per year and eligilbe for the county's CORE Medical plan but not eligible for dental or vision insurance.

Vacation days :

0 - 3 complete years = 80 hours per year.

After 6 months you can take your first week.

3 - 10 complete years = 120 hours per year

10 years = 160 per year

Holidays : 14 paid holidays per year.

Life Insurance through ReliaStar : $50,000.00 County paid. After 65 years of age, pays out 65%, after 70 years of age ReliaStar pays out 32.5%.

Sick Leave : 12 days annual sick leave accrual with unlimited accumulation.

Sick leave is accrued at 3.69 hours for each full 80 hours of payroll period.

60 hours of sick leave can be used for immediate family, parent spouse, child or sibling.

Merit : After successfully completing twenty-six (26) pay periods, a 3.5% merit increase may be granted. Merit increases may be granted annually thereafter to the top step.

Probation Period : New employees remain in a probationary status for 26 pay periods..

Longevity Incentives @ 2.5% for each of the following :

Bi-Lingual pay : $75 per month for specific approved job classifications.

Flexible Spending : Pre-Tax Medical Reimbursement - Max contribution of $2,500 annually

Flexible Spending : Pre-Tax Dependent Care Account - Max contribution of $5,000 annually

Section 125 Plan : Additional insurance is available through the Section 125 plan and may be purchased from a representative during open enrollment or by appointment when they are on-site.

AFLAC

Heart & Stroke Insurance

Cancer Insurance

Accident Insurance

Universal Life Insurance

Short Term Disability Insurance

CALPERS RETIREMENT INFORMATION :

CalPERS :

CLASSIC MEMBERS : 2% at 55

PEPRA MEMBERS : 2% at 62

Extra-Hire's will be enrolled into Public Agency Retirement System (PARS) unless you are already a member of CalPERS.

Additional Retirement Plan :

The County offers a 457 Government plan. Employees can contribute u to this deferred compensation plan ( Pre or Post Tax options ). The County utilizes VALIC.

Participating employees will receive a County paid match of up to $50 a month.

Salary : $150 - $175