What are the responsibilities and job description for the Director of Quality Assurance position at MIDDLE PENINSULA NORTHERN NECK CSB?
About MPNN BH
At Middle Peninsula Northern Neck Behavioral Health (MPNN BH) we work hard to embrace diversity and inclusion and encourage everyone to bring their authentic selves to work each day.
Our purpose is to serve our catchment area with the power of human connection in a compassionate and respectful way. If interested in serving your community while working at a rewarding career, you belong here.
The position of Director of Quality Assurance is responsible for:
- According to critical standards defined by DBHDS regulations and CMS.
- For conformity with DBHDS Licensure service requirements and regulations.
- For conformity with Agency and Division policies and procedures.
- For the appropriateness and clinical necessity of admission, treatment(s) plans and service(s) delivered, including discharge planning activities.
- For conformity with standardized record-keeping requirements.
- For consistency with billing and reimbursement reports.
- For repayment when services did not constitute billing or when billing errors have occurred.
- Development and systematic use of report formats for presenting feedback and identifying problems to service-providing staff, and presenting summary information to supervisors and directors
- Monitoring identified problem areas and/or areas of noncompliance for appropriate corrective action
- Analysis of trends to make recommendations as to policy and procedures to improve the qualitative documentation of services to Agency individuals.
- Plan and implement quality assurance activities to meet overall needs of MPNN BH.
- Coordinate reviews all incidents reports to include level II and III reporting requirements for CHRIS.
- Complete root cause analysis as required by DBHDS for all level II and III incidents, as well as, level I incidents meeting MPNN BH policy thresholds.
- Conduct regularly scheduled audits, client files, staff required training, residential services and case management to insure MPNN BH is meeting all DBHDS and HCBS requirements.
- Serves as Risk Manager per MPNN BH per Risk Management Policy.
- Assist with developing policies and procedures in support of a quality management system.
- To participate, as necessary or desirable, in regular meetings of the clinical and/or administrative staff of the clinical services divisions, and/or of the BH's management team.
- Assist with developing, implementing, conducting regular staff trainings for quality assurance topics like Human Rights, Confidentiality and Release of Records.
- Maintains current records of the clinical competencies and certifications of staff, and to utilize the BH’s IT systems to integrate those records with those reports necessary for payers and regulators.
- Assists with various short and long-term BH projects, including annual and special reports, comprehensive state planning initiatives, demographic and disability-incidence statistical projections that may be related to the provision of quality services.
- Responsible for providing all documentation to the Mortality Review Committees outlined by DBHDS.
- Maintain confidentiality and security of Protected Health Information (PHI) as outlined in the Confidentiality Agreement.
- Maintain/improve knowledge of quality assurance/improvement methods and technologies by participating in development and training activities.
- Participate in State and regional conferences, training and meetings to stay abreast of revision in laws, policies, and regulations as they impact quality assurance activities and the safety/disaster response of the Agency.
- Other duties as assigned
Education/Equivalent Bachelor’s degree in a human services field (Psychology, Social Work; Counseling, or Special Education), or combination of education and work experience that provides the equivalent.
- A minimum of five (5) years of ID/DD/Clinical services in a community setting serving developmental disabilities/mental health, seven (7) or more years preferred.
- A minimum of two (2) years of supervisory experience in a public agency; three (3) or more years preferred.
- Familiarity with DBHDS Licensing, Medicaid Utilization Review Guidelines and Office of Human Right; experience with responding to or implementing corrective action plans.
- Additional Knowledge
- DBHDS Licensure Regulations and Interpretive Guidelines.
- Medicaid Utilization Criteria.
- Managed Care standards and guidelines.
- Applicable Federal, State, and Local regulations.
- Methods of quality assurance, outcome measurements, and program evaluation.
- State Human Rights Policies and Procedures.
- Federal and State requirements for the confidentiality of client records.
- Computer operations, software, and MIS systems.
Must possess valid Virginia Driver's License; CPR/First Aid Certifications, Medication Administration Certification, TOVA. Must be certified tuberculosis free 30 days from hire and annually.
Benefits include:
- Competitive salary
- Comprehensive benefits package including health, dental, and vision insurance (TLC Anthem BCBS)
- Generous paid time off and holiday pay (12 paid holidays, PTO accrued monthly)
- Professional development opportunities
- Retirement plan through Virginia Retirement System (VRS)
- Work site qualified under NHSC, click the link to check eligibility for loan forgiveness http://www.nhsc.hrsa.gov/
The agency of MPNN Behavioral Health maintains a drug free workplace.
Benefits listed are for full time qualifying employees. EOE
