Director, Quality Assurance

Compensation We Offer

• The initial compensation for this position ranges from $113,975 - $140,175 annually; depending on experience, location, and internal equity considerations.

Benefits We Offer

• Benefits Eligibility starts on day ONE
• We provide a robust benefits package which includes medical, dental, vision, See our Benefits Page HERE.
• 401K Employer Match up to 4%
• Competitive Time Off Plans

Must meet eligibility requirements based on employment status

Works within the vision, mission and philosophy of the agency. Oversees the functions of quality assurance and utilization management for the agency-wide services. Works closely with the agency senior leadership to conduct a wide array of quality assurance activities and reporting.

• Develops, implements, and maintains corporate standards, policies and protocols for clinical quality assurance; communicates standards to regional offices; and oversees the effective communication, implementation and monitoring of quality and compliance related corporate standards, policies and protocols in the service regions.
• Collaborates with staff within the department of Quality and Research in all QA related activities. Serves as a communication liaison between compliance, research, outcome and quality assurance activities.
• Develops, maintains, and oversees the implementation and conduct of a Continuous Quality Improvement Plan across all departments and regions.
• Assures reporting and analysis meet various requirements of federal, state and county governments as well as any Accreditation standards as determined by the agency. Works with the Chief Legal Counsel to interpret and resolve conflicts between federal, state and county reporting requirements.
• Supports the development and maintenance of an evaluation system for the effectiveness of clinical quality assurance and compliance activities.
• Analyzes, evaluates, and presents information concerning quality assurance indicators, such as critical incidents, utilization service capabilities, and documentation problems.
• Conducts and oversees continuous quality improvement (CQI) forums to provide clinical quality assurance feedback to regions and clinical programs.
• Develops and maintains tools, in collaboration and coordination with the IT department, for quality assurance data collection and analysis and assists departments in development of program specific quality assurance studies.
• Develops, implements, and monitors clinical risk and utilization management studies in collaboration with clinical leadership team.
• Develops and maintains agency-wide standards, policies and procedures for clinical audit processes, including but not limited to clinical documentation, and oversees and assures the generation of regional audit reports.
• Participates in the resolution of quality assurance technical problems and procedures of departments and recommends solutions or changes in procedures.
• Develops and maintains working relationships with County Quality Assurance departments in collaboration with the regional Directors.
• Assists Quality Support Managers (QSMs) in their role as change agents and supporters within their regions to implement electronic methods to monitor clinical documentation quality.
• Develops quarterly reports for senior management on status of agency quality assurance, clinical risk, utilization management and other key indicators.
• Develops and maintains databases for analytic purposes as well as assuring storage for future analysis and reporting. Researches and documents clinical decision making systems.
• Provides best practice knowledge in the development and maintenance of clinical documentation in an electronic environment.
• Ensures that clinical documentation developed at the corporate and regional levels is consistent, meets all payor and internal quality and compliance standards, eliminates redundancy, incorporates outcome measures, and are structured and allow for analysis of clinical information.
• Reviews data values captured within the Electronic Health Record (EHR) for accuracy and maintenance of County, State and other regulatory changes/values.
• Assures quality and integrity of clinical databases and master data tables.
• Ensures the Electronic Health Record meets quality and audit standards.
• Supports development of quality assurance, outcomes and research, and compliance related technology processes.
• Assures appropriate communication within and between departments, corporate, regional and agency staff.
• Performs other responsibilities, as assigned, to support department/business needs.

• To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform essential job functions.
• Bachelors degree (B.A./B.S.) in mental/behavioral health. Five (5) years experience in the health care industry. One (1) of these years must include substantive experience implementing utilization review and/or quality assurance processes. The position also requires knowledge of Quality Improvement processes. Comprehensive knowledge of Medi-Cal regulations