Quality Improvement Specialist

Job Overview: The Quality Improvement (QI) Specialist  is an integral part of the QI team ensuring that quality services provided to consumers are appropriately documented, securely stored, monitored and evaluated in accordance with DC Department of Behavioral Health, DC Healthcare Finance, Medicaid, HIPAA, 42 CFR regulations, and CARF Behavioral Health standards for the purpose of achieving excellence in direct clinical service delivery. The QI Specialist will also lead technical discussions to establish and implement solutions for how to effectively and efficiently use the capabilities of the Credible EHR. This role requires a keen eye for detail, analytical skills, technical acumen and the ability to collaborate with cross-functional teams to drive continuous improvement. 

Schedule: Monday-Friday,  8:30 AM to 5PM. Hybrid schedule available after a 30 day new-hire period. Primary office is located in Washington, DC but occasionally travels to various locations within Washington D.C. and Montgomery County MD as needed. 

Key Responsibilities:

Electronic Health Records Management

• Acquire Credible EHR Administrator and Credible Business Intelligence certification & serve as an internal subject matter expert (SME) for the EHR system.

• Monitor access and control procedures for the agency's electronic health records ensuring proper use, access and permissions for all staff. Provide assistance to users as needed.

• Monitor the agency's CRISP HIE system, remain knowledgeable of use and updates.

• Create/revise forms, optimize reporting capabilities, and promote system integrity. 

• Monitors system performance to determine most efficient and effective means to operate.

• Collaborate with cross-functional teams to design, document and implement process enhancements and new workflows as needed.

Data Collection, Analysis & Reporting:

• Conduct regular audits per Department of Behavioral Health (DBH) Claims Audit Tool, Quality Review Tool, clinical care guidelines and other regulatory requirements

• Proactive monitoring of  medical record documentation,  and quality metrics.

• Managing/tracking client episodes ( deaths, hospitalizations, incarcerations, etc).

• Use statistical tools and methodologies to identify trends and patterns.

• Prepare reports and presentations to communicate findings and recommendations.

Training & Policy Updates

• Develop training resources/user manuals for use in staff onboarding and ongoing quality improvement/assurance.

• Provide training to employees on various topics including proper use of the electronic health records, note documentation, quality improvement & compliance best practices and more.

• Assist with the development of documentation requirements for new and/or changing business processes.

Accreditation & Certification 

• Work closely with the QI Director to complete certification  requirements.

• Participate in preparing  pre-survey documents for surveyor review and coordinating organizational response during CARF, DBH, and third-party surveys.

• Monitor compliance with regulatory, contractual and accreditation standards through ongoing organizational assessment.

Other duties as Assigned

Required Knowledge, Skills and Abilities 

• 3 years experience in quality management, auditing and process improvement. 

• Experience with electronic health records administration, for a behavioral health environment

• Experience with building business intelligence dashboards and/or complex reports.

• Especially skilled in use of Microsoft Office Suite, including SharePoint.

• A high moral compass and a champion of continuous quality improvement.

• Ability to work independently and set priorities; capacity to maintain a helpful role.

• Willingness to learn new skills and take on new challenges as department needs evolve.

• Excellent communication and interpersonal skills; a team player. 

• Dependable and action oriented; takes initiative in identifying and proposing solutions.

• Ability to handle sensitive information and maintain confidentiality.

• Deep commitment to the mission, values, and goals of PTHDC.

Preferred Qualifications

• Bachelor's degree in a relevant field (administration, healthcare management, IT).

• Recent experience using Credible Behavioral Health EHR is a plus

• Experience with DBH MHRS policies, Medicaid billing guidelines, and industry best practices.

• Experience with CARF and/or other accreditation bodies (i.e. JCAHO, NCQA). 

• Experience with SQL, programming and coding.