What are the responsibilities and job description for the Temporary Quality Improvement Specialist position at Main Street Direct?
Description
Schedule:
Full-Time: 40 hours per week, flexible schedule. Hybrid remote with in person training period.
Tentative End Date: 7/11/2025
Summary
Under the direction of the Outpatient Operations Director, the Quality Improvement Specialist will conduct audits of patient case records for the purpose of identifying documentation errors. The Quality Improvement Specialist is responsible for reviewing and verifying the overall quality and completeness of clinical documentation. This individual facilitates modifications to clinical documentation through extensive interaction with physicians, nursing staff, and counseling staff to ensure that completed documentation reflects a clear and accurate depiction of services delivered and the chart is in compliance so the service can be billed for and paid by the insurance company, and meets all regulatory and agency procedures. In addition, the Quality Improvement Specialist will be responsible for extracting, compiling, and reporting data from the electronic health records system. The Quality Improvement Specialist will provide ongoing monitoring and systematic review to ensure that entries in records follow established procedures to meet accreditation requirements. This role will provide training in records management to assist the clinician and organization in improving the quality of services provided to each person served.
Essential Job Functions
Minimum Job Qualifications:
Required: High School Diploma or GED, highly proficient in MS Excel and other applications, and must subscribe to a professional code of ethics.
Preferred: A two-year degree in the field, particularly in statistics, math, business administration, or computer science; equivalent experience will be considered
Other Job Requirements
Required: Must maintain a valid Drivers License, as specified in the personnel policies. Must maintain all laws and policies concerning corporate compliance, confidentiality, security, and patient rights as specified in the employee manual, 42 CFR Part 2, and HIPAA.
Schedule:
Full-Time: 40 hours per week, flexible schedule. Hybrid remote with in person training period.
Tentative End Date: 7/11/2025
Summary
Under the direction of the Outpatient Operations Director, the Quality Improvement Specialist will conduct audits of patient case records for the purpose of identifying documentation errors. The Quality Improvement Specialist is responsible for reviewing and verifying the overall quality and completeness of clinical documentation. This individual facilitates modifications to clinical documentation through extensive interaction with physicians, nursing staff, and counseling staff to ensure that completed documentation reflects a clear and accurate depiction of services delivered and the chart is in compliance so the service can be billed for and paid by the insurance company, and meets all regulatory and agency procedures. In addition, the Quality Improvement Specialist will be responsible for extracting, compiling, and reporting data from the electronic health records system. The Quality Improvement Specialist will provide ongoing monitoring and systematic review to ensure that entries in records follow established procedures to meet accreditation requirements. This role will provide training in records management to assist the clinician and organization in improving the quality of services provided to each person served.
Essential Job Functions
- Work with the Outpatient Operations Director and the outpatient management team to complete full audits of patient health records.
- Ensures all services provided by the programs can be paid for by insurance companies, by maintaining documentation compliance in accordance with the directives and guidelines of the OASAS, OMH, OMIG, DOH, CARF and/or any other governing or licensing agencies.
- Acts as liaison to inform the appropriate physician, nursing staff, or counseling staff member of any documentation errors that are found during quality assurance documentation reviews and trainings.
- Review both concurrently and retrospectively medical records and pertinent documentation in accordance with established site review tools and company policy.
- Extracts, compiles, analyzes, and reports on data from the electronic health records system.
- Prepares periodic reports on quota, waiting lists, case type, acuity level, demographic information, and other criteria as specified. May be asked to present findings.
- Utilize MS Excel spreadsheets to track documentation workflow and provide status reports in the form of tables, charts, and graphs.
- Communicates with billing department the readiness of services to be billed.
- Upholds the standards of Credo’s Continuous Quality Assurance Program.
- Participation in Continuous Quality Improvement Committee meetings, as assigned.
- Maintaining documentation, correspondence, and communication to and from other providers regarding psychiatric, medical and substance abuse services
- Promotes individual professional growth and development by meeting requirements for mandatory/continuing education and skills competency.
- Will provide training to clinicians and administrative staff. Will be required to perform other duties as requested, directed or assigned.
Minimum Job Qualifications:
Required: High School Diploma or GED, highly proficient in MS Excel and other applications, and must subscribe to a professional code of ethics.
Preferred: A two-year degree in the field, particularly in statistics, math, business administration, or computer science; equivalent experience will be considered
Other Job Requirements
Required: Must maintain a valid Drivers License, as specified in the personnel policies. Must maintain all laws and policies concerning corporate compliance, confidentiality, security, and patient rights as specified in the employee manual, 42 CFR Part 2, and HIPAA.
