Quality Manager – Mental Health

At Wellpoint Care Network, our mission is to facilitate equity, learning, healing, and wellness by restoring the connections that help children and families thrive.

Every person deserves the opportunity to reach their fullest potential. It’s part of human nature, and the promise of our country, that everyone be given a fair chance to be and do their best. Yet, many in our community live with unresolved childhood and generational trauma.  

That’s where we come in. We believe we can create a world where children and families have a clearer path to their fullest potential. Wellpoint Care Network has championed the restoration of families for nearly 175 years.

Job Purpose: 

Our next Quality Manager – Mental Health will be responsible for overseeing management processes to ensure accuracy, consistency, and compliance with regulations and standards. The position leads quality assurance initiatives and data integrity efforts to support effective reporting, decision making, and service delivery.

Qualifications: 

• Bachelor’s degree in human services or business field required. 
• Master’s degree in human services or business field preferred.
• Minimum two (2) years of experience in Behavioral Health field required. 
• Minimum two (2) years of experience in CMS federal and state regulatory compliance, quality assurance, or data management required.
• Demonstrated knowledge of the law and regulations pertaining to behavioral health, children, youth, and families.
• Awareness of best practices for data privacy, security, and ethical data handling.
• Ability to define problem areas, assemble facts, and recommend solutions.
• Ability to adapt and respond quickly to obstacles, be flexible and resilient when faced with multiple demands by shifting priorities.
• Proficient in the usage of computer software; demonstrate an understanding of computer file systems and computer software packages, e.g., Microsoft Office, Excel, Outlook, Teams, ADP, etc.
• Must be honest, dependable, and able to meet deadlines; Self-motivated and able to work independently.
• Physical exam, drug screen, motor vehicle report, and background checks are required for this position.
• A valid Wisconsin Driver’s License or occupational driver’s license, reliable transportation and insurance is required.

Duties:

Regulatory Compliance and Quality Assurance   

•Monitors programs (Clinic, SBMH, OT, Medication Management, and CCS Care Coordination and Ancillary) and services to ensure that all licensing and regulatory requirements are met, including monitoring program records and files. (CBHC, DHS 75.50, COA, DHS 36). 

•Maintains tracking systems sufficient to accurately assess individual performance and makes recommendations for necessary adjustments to stay compliant.

•Conducts regular audits of client charts, employee training requirements, supports RCSL financial audits to identify and rectify discrepancies, which includes documenting efforts to achieve 100% compliance with client file requirements.

•Reviews compliance/performance outcomes, identifies protocol enhancements, and develops recommendations for review for the purpose of improving compliance and outcomes within the programs.

•Ensures compliance with on-call services for emergencies, collaborating partners, internal cross-department collaboration, community partners, and independent contractors. 

•Upholds Department and Agency-wide policies, procedures, and program/administrative changes.

Program Administration Support 

• Provides guidance or training on recommended improvements, deficiencies, areas of concern.

•Supports clinical supervisors and intake specialists in monitoring case assignments, reporting on time to service measures, and ensuring quality service delivery.

•Reviews reports and data for distributing to internal departmental requests, state entities, and federal reporting.

•Responds timely to requests for outcomes, data, records requests, audit requests, and tracks communication to all reviewing entities.

•Collaborates with other internal and external stakeholders to enhance cross-departmental practices.

Program Leadership

• Works towards improving the overall performance of programs by identifying innovative, responsive solutions.

•Organizes time effectively, maximizes use of available resources, successfully balances the competing demands of multiple projects by setting priorities and communication of deadlines.

•Abides by the standards of one’s professional licensing organization.

•Seeks to improve clinical skills through research, training, and consultation.

Agency Engagement 

• All employees will be evaluated on their demonstration of a consistent commitment to the Agency’s Seven Essential Ingredients, Diversity, Equity and Inclusion, and engagement in the strategic initiatives of the organization. This will be measured by their active participation in committees and workgroups, and by their communication and practice within their daily work and in the community.

• Participates in assigned meetings, events and learning as required.

•Supports Clinic Coordinator in managing clinical space needs and issues.

•Other duties as assigned, including serving in a coverage role for other department members.

Position Details & Extras:

• Full time.
• Onsite / Hybrid work is available with reliable broadband connection.
• Moderate exposure to noise.
• Public Service Loan Forgiveness (PSLF) - Wellpoint employees may be eligible for loan forgiveness under the Public Service Loan Forgiveness program. 
• Regular travel in personal vehicles is required with the ability to move intermittently throughout the workday.

Organizational Information: 

At Wellpoint Care Network, we have seen exactly how trauma, poverty, systemic racism, social injustices, and other barriers create instability in all areas of life. The people in our care face education and health disparities, high unemployment rates and unaffordable housing. What’s worse, many have lost connections to resources, family, friends, and other support systems. We have seen the toll it has on a person’s physical, emotional, and financial well-being to try and successfully navigate complex systems that may have failed them in the past.

We believe there is a better way. So, we have anchored ourselves in our 170 years of caring for our neighbors through modernized human services.

Wellpoint Care Network provides a rich continuum of services, including:

•        Child Welfare and Foster Care 

•        Support for youth who have aged out of care

•        Care Coordination and Wraparound services 

•        Mental health therapy and supports such as our Clinic, Family Preservation, Caregiver Support, and Integrated Community Treatment

•        Professional education and clinical consultation (for organizations, schools, and individual/family) 

Wellpoint Care also works to promote a diverse and caregiving environment to ensure that those we serve and employ are valued, accepted, respected, and treated equitably.

•        Equity means we work tirelessly toward fair and just treatment, systems, and policies. At Wellpoint Care Network, we believe that we are accountable – individually and collectively – when inequity or injustice replaces equity and inclusion. 

•        Inclusivity means that we consciously build groups that welcome and celebrate differences in age, race, ethnicity, class, gender, sexual orientation, religion, gender expression, education, socio-economic background, personal history, geographical location, marital status, parental status, and work experiences.   

Interested parties please apply online. We are committed to enhancing diversity, equity and inclusion and strongly encourage minority candidates to apply. For more information, visit our website www.wellpointcare.org.

Equal Opportunity Employer