Quality Improvement Manager

The Quality Improvement Manager is a member of Thresholds Quality team. The QIM reviews medical records and conducts utilization reviews to ensure quality and consistency of services and documentation across programs. The QIM may make suggestions, implement improvement and corrective action plans, and deliver hands-on training for improvement. The QIM will also lead continuous quality improvement initiatives partnering with clinical leadership, clinical program staff and evaluation specialists.  

 ESSENTIAL DUTIES & RESPONSIBILITIES 

Responsible for in-depth review and evaluation of operational systems, documentation, and service delivery according to the expectations and regulations of the various funding sources and with the highest professional standards. This may include but is not limited to the standards and documentation requirements as established by: CARF, Medicare, Medicaid, DMH, CILA, SUPR, DOL, CCBHC, DORS and/ or DCFS.

· Meets regularly with leaders, program managers, and teams to support program innovation and solution generation, operationalize quality improvement efforts, monitor progress, facilitate discussion of quality improvement barriers, and summarize efforts for program decision making.

· Collaborates with research and evaluation to conduct ongoing evaluation of the validity and reliability of quality improvement measures.

· Collaborates and provides consultation with Program Directors to assist in completion of detailed reports highlighting quality improvement outcomes as well as efficiency of measures used.

· Identifies areas where billing (Medicaid/Medicare/Commercial) billing could be maximized. This includes reviewing billable notes, identifying individual staff and team-related struggles with note writing and billing; and developing individual and team improvement plans to effectively address issues.

· Identifies areas for improvement and in collaboration with the Program Director, puts improvement plans and corrective actions in place.

· Provides direct hands-on training for new staff and ongoing staff training on documentation and makes recommendations as to additional training and support needed for staff.

· Responsible for helping programs create and enhance a therapeutic environment.

· Attends and participates in task force meetings and other agency-wide committees as assigned.

· Oversees and provides clinical direction and coaching/training as to the development and review of members’ assessments and treatment plans, as well as any additional screening, assessment, goal planning tools and evidence-based practices used by clinical programs.

· Develops criteria by which to review the delivery of all departmental services and makes recommendations to assure they operate using the values and principles of recovery.

· Ensures that the Quality department functions optimally, in conjunction with other branches or departments of Thresholds.

· Assures that all Thresholds records are organized in a systematic and organized fashion. Follows all appropriate safeguards with regard to the confidential files maintained at the program. Follows all policies and procedures pertaining to records including but not limited to restricting access to all records per agency policy.

· Provides accurate and timely information to superiors on all topics and issues related to the operation of the agency and the well-being of its staff and members.

· Other duties as assigned.

MARGINAL DUTIES & RESPONSIBILITIES

· May be required to participate in crisis intervention when necessary.

· May be required to co-lead groups, sign-off on treatment plans, or provide other clinical services as needed to facilitate the quality of services across programs.

EDUCATION

· Office of Mental Health Rule 132 credential requirements for a Qualified Mental Health Professional (QMHP) including a Master’s degree in social work, counseling, psychology or closely related field is required.

EXPERIENCE

· Four (4) years of prior direct clinical experience preferred.

· Demonstrated management experience at an appropriate senior level, including establishing, leading and managing large teams and resources.

· Ability to work effectively with staff at all levels of the organization.

· Ability to function in a computer oriented office, including working knowledge of pertinent software.

Salary Range: $52,000 - 70,000

SKILLS/CERTIFICATIONS

· LSCW, LCPC preferred.

· IM+CANS certification.