PPM II - Quality Review Specialist

King County   Seattle, WA   Full-time     Manufacturing / Production / Operations
Posted on November 24, 2021
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Summary

The Department of Community and Human Services values diverse perspectives and life experiences. The Department encourages people of all backgrounds to apply, including Black, Indigenous, and People of Color, immigrants, refugees, women, LGBTQ, people with disabilities, veterans, and those with lived experiences.  

 
 King County's 
Department of Community and Human Services (DCHS) provides equitable opportunities for people to be healthy, happy, and connected to community.

The Behavioral Health Quality Review Specialist will manage quality review activities in the Behavioral Health and Recovery Division (BHRD). These include working with internal and external partners to review for quality deliverables, provider and network performance, client satisfaction and audit expectations.


The incumbent in this position will align all work with the mission of the Department's Equity and Social Justice strategic plan (i.e., to reinforce and embed equity and social justice principles into policies, practices, attitudes, and actions that produce equitable access, opportunities, treatment, impacts and outcomes for all.


WHO MAY APPLY: This position is open to all qualified candidates that meet the minimum qualifications. 

REQUIRED MATERIALS: Candidates who wish to be considered for this position must submit an online King County application and respond to the supplemental questions. Your application may be rejected as incomplete if you do not include the requested and relevant information in the online application and supplemental questionnaire. Applications and/or supplemental questionnaires that state, “see my resume” are considered incomplete and will not be considered to be competitive.

WORK SCHEDULE/CONDITIONS: This position is scheduled to work 40 hours per week, Monday - Friday, 8am - 5pm. This position meets the provisions of the Fair Labor Standards Act and is overtime eligible with supervisory pre-approval.

The work associated with this position will be performed through a combination of teleworking, complemented with onsite work and meetings as needed. Employees will have access to shared workspaces at various King County facilities. Employees must reside in Washington state and within a reasonable distance to their King County worksite to respond to workplace reporting requirements.

Employees will be provided with a County issued laptop and must maintain a workspace with an internet connection (access may be supplemented in some situations) where they can reliably perform work and remain available and responsive during scheduled work hours. Please note that when an employee conducts work that is likely to bring them in contact with another individual, safety precautions are requiredincluding the wearing of masks in some situations. King County is doing its part to reduce the spread of COVID-19 and remains committed to reducing our carbon footprint.

King County has a robust collection of tools and resources to support working remotely. The individual selected for this opportunity will be joining an innovative and progressive team that is redefining how we work as we transition to the department's hybrid environment.  

RECRUITER:  Annette Coleman; ancoleman@kingcounty.gov

Job Duties

  • Supports and coordinates quality review activities including reviewing, analyzing and auditing providers to structure effective and manageable quality and performance plans.
  • Serves as a provider relations quality liaison within the King County Integrated Care Network (KCICN) framework which includes working with providers on audit expectations, performance improvement plans, and coordinating status updates.
  • Participates in meetings with internal and external stakeholders, including contracted provider agencies and King County contract staff to review provider input and updates related to strategizing towards performance benchmarks and quality standards.
  • Review plans to ensure the inclusion of reasonable interventions that are undertaken to address causes/barriers identified through process analysis, quality improvement initiatives, methodologies for sustained improvement through repeated measurements over comparable time periods, and any mitigation hazards.
  • Work in collaboration with the Quality Improvement Specialist and Quality Assurance Specialist to incorporate key attributes into improvement plans based on identified initiatives as well as individual provider level performance needs related to clinical and non-clinical outcomes.
  • Develop strategies, survey procedures, and sampling methods to maximize participation, effectiveness, and validity of provider network survey results.
  • Analyze information on client satisfaction of behavioral health services in King County.
  • Create reports on findings for submission to quality committees as part of an overall strategy to include feedback from service participants and families in the ongoing quality improvement plan.
  • Supports the maintenance of BHRD Policies and Procedures and the Provider Manual to ensure inclusion of quality review protocols and to set expectations both internally and externally to ensure efficient communication across partners.
  • Coordinates with the Client Services Specialist, Quality Assurance Specialist, and Quality Improvement Specialist to identify and support quality initiatives under the direction of the Quality Manager.
  • Coordinate with the Behavioral Health Recovery Specialist on identifying and including cultural, linguistic and recovery-oriented processes as applicable to Quality.
  • Coordinates with the Contracts section and Performance, Measurement and Evaluation (PME) to strategize on quality review activities for providers.
  • Support the Quality Improvement Committee (QIC), the Quality Committee (QC), the Performance workgroup, as well as other quality department efforts.
  • Perform other related duties as assigned.

Experience, Qualifications, Knowledge, Skills

  • At least 5 years of professional experience in public sector behavioral or health services, and a bachelor’s degree; or an equivalent combination of experience and education.
  • Experience working in provider relations in the health or behavioral health sector.
  • Demonstrated ability to develop, review, monitor and audit quality and performance plans in a behavioral health or healthcare setting.
  • Experience in research concepts, survey design and sampling methods.
  • Experience working with affiliated service systems at the local, regional, and state levels.
  • Knowledge of and experience with federal, state, and regional rules, regulations, and contract requirements pertaining to behavioral health managed care (e.g., CFR, RCW, WAC). Demonstrated experience producing reports for professional and community audiences.
  • Knowledge of and experience working within the substance use disorder and mental health services in a clinical or administrative role in King County and/or Washington State, or equivalent experience in another state.
  • Proven ability to work effectively with individuals who may have markedly different perspectives.
  • Knowledge of and experience with the special needs of culturally diverse populations.
  • Knowledge of behavioral health recovery principles and practices.
  • Strong written and verbal communication skills.
  • Ability to use innovative thinking and identify best practices to approach problems, resolve conflicts, and inform program implementation.
  • Ability to manage multiple priorities and deadlines simultaneously.
  • Ability to work independently and effectively as a team member to coordinate accomplishment of specific tasks.
  • Working knowledge of Microsoft Office Suite including Excel, PowerPoint, e-mail, and the internet.
  • Valid Washington State Driver's License, or the ability to travel throughout the county in a timely manner.  

 Desired Experience, Qualifications, Knowledge & Skills

  • The incumbent in this position will have lived experience or a strong knowledge about recovery from mental health, substance use or co-occurring disorders.
  • Qualified Mental Health Professional as defined by Washington Administrative Code 388-865-0150 and 0260, and/or Certified Chemical Dependency Professional (CDP), as defined by WAC 246-811-010 and RCW 18.205.
  • Experience developingreviewing, auditing, and monitoring quality and performance plans in a managed care and/or provider network setting.
  • Experience working with King County or other contracted behavioral health providers.
  • Experience working with populations that have co-occurring mental illness and substance use disorders. 

Supplemental Information

Forbes recently named King County as one of Washington State's best employers.

Together, with leadership and our employees, we're changing the way government delivers service and winning national recognition as a model of excellence. Are you ready to make a difference? Come join the team dedicated to serving one of the nation's best places to live, work and play.

Guided by our "True North", we are making King County a welcoming community where every person can thrive. We value diversity, inclusion and belonging in our workplace and workforce. To reach this goal we are committed to workforce equity. Equitable recruiting, support, and retention is how we will obtain the highest quality workforce in our region; a workforce that shares and will help advance our guiding principles--we are one team; we solve problems; we focus on the customer; we drive for results; we are racially just; we respect all people; we lead the way; and we are responsible stewards. We encourage people of all backgrounds and identities to apply, including Native American and people of color, immigrants, refugees, women, LGBTQ+, people living with disabilities, and veterans.

COVID-19 Vaccination Requirement

King County Executive Branch employees are required to be fully vaccinated against COVID-19. If you are the successful candidate for the position you applied for, the County will send you a conditional offer letter.

As a condition of employment, prior to a final offer of employment, you will be required to:

  • submit proof of vaccination, or
  • have an approved request for medical or religious exemption and an approved accommodation. Philosophical, political, scientific, or sociological objections to vaccination will not be considered for an exemption or accommodation.

People are considered fully vaccinated against COVID-19 two weeks after receiving the final dose of a vaccination approved by the Center for Disease Control and Prevention (CDC).

The Executive Branch includes employees in the Executive branch, the Assessor's Office, Elections, the King County Sheriff's Office, and the Executive Office.

King County is an Equal Employment Opportunity (EEO) Employer

No person is unlawfully excluded from employment opportunities based on race, color, religion, national origin, sex (including gender identity, sexual orientation and pregnancy), age, genetic information, disability, veteran status, or other protected class. Our EEO policy applies to all employment actions, including but not limited to recruitment, hiring, selection for training, promotion, transfer, demotion, layoff, termination, rates of pay or other forms of compensation.

To Apply

If you are interested in pursuing this position, please follow the application instructions carefully. If you need this announcement in an alternate language or format, would like to request accommodation or assistance in the application or assessment process or if you have questions please contact the recruiter listed on this job announcement.

King County offers a highly-competitive compensation and benefits package designed to meet the diverse needs of our employees and support our employees' health and well-being.  Eligible positions receive the following benefits and have access to the following programs:

  • Medical, dental, and vision coverage: King County pays 100% of the premiums for eligible employees and family members
  • Life and disability insurance: employees are provided basic coverage and given the opportunity to purchase additional insurance for both the employee and eligible dependents
  • Retirement: King County employees are eligible to participate in a pension plan through the Washington State Department of Retirement Systems and a 457(b) deferred-compensation plan
  • Transportation program and ORCA transit pass
  • 10 paid holidays each year (plus 2 personal holidays)
  • Generous vacation and paid sick leave
  • Paid parental leave, family and medical leaves, and volunteer leave
  • Flexible Spending Account
  • Wellness programs
  • Onsite gyms and activity centers
  • Employee giving program
  • Employee assistance programs
  • Flexible schedules and telecommuting options, depending on position
  • Training and career development programs
For additional information about employee benefits please visit our Benefits, Payroll, and Retirement Page.

This is a general description of the benefits offered to eligible King County employees, and every effort has been made to ensure its accuracy.  If any information on this document conflicts with the provisions of a collective bargaining agreement (CBA), the CBA prevails.  Also, in the event of any incorrect information in this document, applicable laws, policies, rules, CBAs, or official plan documents will prevail.
 
NOTE:  Benefits for Term Limited Temporary (TLT) or Short Term Temporary (STT) positions, including leave eligibility and/or participation in the pension plan through the Washington State Department of Retirement Systems, will vary based upon the terms and details of the position. Short Term Temporary positions are not eligible for an ORCA transit pass.
 
For inquiries about the specifics of this position, please contact the recruiter identified on this job posting.

01
Are you applying to this position as an eligible Current or Previous King County Employee Priority Placement Program Participant AND Is this position the same or lower percentage of full-time when compared to the position held at the point of the notification of layoff AND Do you possess the skills and abilities to qualify for this position?
  • Yes, I was given a layoff notice from my role at King County AND I am within two years of the effective date of my layoff. AND The position I was laid off from was the same or a higher percentage of FT status when compared to this one.
  • No.
02
If you answered yes to the question above and you are applying for this position as a Priority Placement Participant, to be considered, you must provide the following three pieces of information in the space provided: 1. The title you held when you received your layoff notice 2. The department you worked in 3. The effective date of your layoff
03
Do you have at least five years of professional experience in public sector behavioral or health services and a bachelor's degree; or an equivalent combination of experience and education?
  • Yes
  • No
04
Have you worked in provider relations in the health or behavioral health sector? Please describe your role, the size and scope of the network, as well as how you coordinated and developed quality review activities and monitored change practices for the network.
05
Please describe your experience as it relates to developing quality or performance plans and auditing for compliance.
06
Please describe your experience reviewing, developing, and/or refining surveys to understand the needs of clients and/or communities.
07
King County has transformed its work on equity and social justice from an initiative to an integrated effort that applies the principle of "fair and just" intentionally in all the County does in order to achieve equitable opportunities for all people and communities. What is the most important equity or social justice issue to you and why?

Required Question