Quality & Compliance Specialist - Crisis

Principals

• Evaluates and monitors the Quality of care for Crisis Care Services.
• Interprets, formulates, and maintains continuous quality improvement (CQI) and assurance programs.
• Performs quality assurance reviews to ensure quality services consistent with national industry standards, compliance, and state regulations.
• Creates performance improvement projects based on quality analysis.
• Prepares quality documentation and reports by collecting, analyzing, and summarizing information and trends.
• Reviews quality outputs for compliance (internally and externally).
• Affirms that clinic policies meet PIHP, State, Federal, Joint Commission, and all other accreditation standards.
• Reviews agency and State policies and ensures consistency in implementation.
• Prepares regular reporting based on organization and certification-related requirements.
• Interprets, applies, and recommends changes to organizational policies and procedures.
• Completes incident reports, critical and sentinel event reporting, root cause analysis, and improvement plans as applicable.
• Prepares the clinic and programs for accreditation, such as the Joint Commission, and assists in leading site reviews.
• Drafts written reports and presentations related to evaluation processes and findings.
• Develops and trains staff on protocols, procedures, policies, and compliance standards.
• Works with a cross-functional team to define and develop analysis plans, ensure data quality standards, and create ready results.
• Utilizes a systematic method to collect and analyze data and identify gaps and areas of strength.

Knowledge, Skills, and Abilities

• Knowledge of DWIHN policies, procedures, and practices.
• Knowledge of the principles of quality improvement.
• Knowledge of Critical/Sentinel Event policies and procedures.
• Knowledge of Quality Assurance.
• Knowledge of accreditation and certification standards related to the provision of mental health, developmental disability, and substance use disorder services.
• Knowledge of the DWIHN provider network.
• Knowledge of medical and behavioral health practices and terminology.
• Knowledge of compliance standards.
• Knowledge of the Medicaid screening process.
• Knowledge of MDHHS policies, rules, regulations, and procedures.
• Knowledge of health care fraud and abuse laws, including the False Claims Act, Stark Laws, and the Anti-Kickback Statute, including the associated penalties.
• Knowledge of health care law, regulations, and standards.
• Knowledge of governmental compliance regulations.
• Knowledge of contracting policies and procedures.
• Knowledge of Quality Management and Improvement principles and practices.
• Knowledge of HIPPA Compliance.
• Corrective Action skills.
• Computer skills.
• Time management skills.
• Organizational skills.
• Critical thinking skills.
• Teamwork skills.
• Conflict Resolution skills.
• Decision Making skills.
• Project Management skills.
• Assessment skills.
• Report writing skills.
• Communication skills.
• Multitasking skills.
• Analytical skills.
• Ability to communicate orally.
• Ability to communicate in writing.
• Ability to work effectively with others.
• Ability to work with an ethnically, linguistically, culturally, economically, and socially diverse population.
• Judgment/Reasoning ability.

Education

• A Bachelor’s degree from a recognized college or university in Human Services, Social Services, Nursing, Public Health, Public Administration, Healthcare Administration, Health Management, Epidemiology, or a related field is required.
• A Master’s degree in one of the fields listed above is preferred.

Experience

• Four (4) years of professional experience in a behavioral healthcare or mental health setting, including two (2) years of professional experience in the following:
• Quality Management and Accreditation.
• Statistical analysis of health care data, metrics, systems, and standards.

Licenses

• A valid State of Michigan Driver’s License with a safe and acceptable driving record.
• Certified Professional in Healthcare Quality certification preferred.

Working Conditions

• Work is usually performed in an office setting, but requires the employee to drive to different sites throughout Wayne County and the State of Michigan.

Company Information

• The Detroit Wayne Integrated Health Network is an Equal Opportunity Employer.

COVID-19 Vaccination Requirement

This position requires proof of being fully vaccinated for COVID-19 as a condition of employment. Medical or religious accommodations or other exemptions that may be required by law will be approved when properly supported. Further information will be provided during the recruitment process.