Quality Assurance Specialist PPM III
King County
Auburn, WA
Full-time
Manufacturing / Production / Operations
Posted on June 19, 2019
- Summary
- The Department of Community and Human Services (DCHS) values diverse perspectives and life experiences. The Department encourages people of all backgrounds to apply, including people of color, immigrants, refugees, women, LGBTQ, people with disabilities, veterans and those with lived experience.
The Department of Community and Human Services (DCHS) provides equitable opportunities for people to be healthy, happy, self-reliant and connected to community.
The Behavioral Health Quality Assurance Specialist will manage quality assurance activities in the Behavioral Health and Recovery Division (BHRD). These include working with internal and external partners to assure quality of clinical services for the citizens of King County and ensure that services meet regulatory and accreditation standards and contract requirements.
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. The Department of Community and Human Services values diverse perspectives and life experiences. The Department encourages people of all backgrounds to apply, including people of color, immigrants, refugees, women, LGBTQ, people with disabilities, veterans, and those with lived experiences.
Work Schedule: This position is exempt from the provisions of the Fair Labor Standards Act, and is not overtime eligible. Typical hours are Monday - Friday 8am-5pm.
Recruiter: Annette.Coleman@kingcounty.gov - Job Duties
- Supports and coordinates internal risk and quality management activities including compiling, analyzing, and determining trends and areas warranting improvement for grievances and critical incidents, and oversees required reporting to the Health Care Authority (HCA)
- Supports and coordinates quality-related HCA contract deliverables, including participation in network and internal meetings to make recommendations and identify and support the development of Quality Assurance and Improvement Metrics, ensuring metrics are aligned with BHRD's quality strategy, contractual and regulatory requirements, program integrity principles, as well as the HCA's quality strategy
- Leads development and maintenance of BHRD Policies and Procedures to ensure contract and regulatory compliance
- Develops strategic plan to ensure regulatory compliance with contract and statutory requirements including those in the CFR, WAC, RCW, and NCQA regulatory bodies for quality management topics such as access, capacity, authorization processes, provider credentialing, client rights, coordination and quality of care, practice guidelines, service utilization, and evidence based practices
- Provides technical assistance and guidance in developing tools and processes for site reviews and managed care organization pre-delegation and delegation reviews to ensure quality of care and regulatory compliance of contracted providers
- Coordinates with the Quality Improvement Specialist to support and identify improvement initiatives
- Coordinates with the Contracts section and Performance, Measurement and Evaluation (PME) section to develop strategies for encounter data validation monitoring among contracted providers
- Coordinates with the Compliance Officer and other Department and Division staff to ensure Quality Program is aligned with Program Integrity principles and projects
- Support the Coordinated Quality Improvement Program (CQIP) Quality Improvement Committee/Safety and Incident Management Meeting
- Perform other related duties as assigned
- Experience, Qualifications, Knowledge, Skills
- At least 5 years of professional experience in public sector behavioral or primary care health services, and a graduate degree with coursework in social or health care services or healthcare administration; or an equivalent combination of experience and education.
- Experience working as a quality assurance manager, compliance officer, and/or quality improvement manager in the health or behavioral health sector.
- Demonstrated ability to utilize continuous quality improvement approaches to improve quality of care in behavioral health or health care settings.
- 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 collecting, managing, and analyzing data and with using data as a quality management tool to further continuous quality improvement.
- 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.
- Excellent interpersonal skills.
- Working knowledge of Microsoft 2016 Office Suite, e-mail, and the internet.
- Valid Washington State Driver's License, or the ability to travel throughout the county in a timely manner.
- The most competitive candidates will also have the following desired qualifications:
- 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 working with King County or other behavioral health contracted behavioral health providers.
- Experience working with populations that have co-occurring mental illness and substance use disorders.
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
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.
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01Have you had at least five years of professional experience in public sector or primary care health services?
- Yes
- No
02Have you had either formal graduate education in social or health care services or administration, or relevant equivalent experience?- Yes
- No
03Have you worked as a quality assurance manager, quality improvement manager, or compliance officer in primary care or behavioral health?- Yes
- No
04Are you a Qualified Mental Health Professional?- Yes
- No
05King 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