Overview

Quality Control Specialist Jobs in Lakeview, OR at Collins Pine Company

Quality Management Specialist I:

This is the entry-level position in the Quality Management series. The incumbent is expected to work independently and have a very good understanding of the functions within the assigned HHSA Division, the methodologies to perform required tasks. Responsibilities include collaboration and coordination with staff, leadership, and external stakeholders to enhance service delivery, meeting regulatory standards, and promote equitable access to care.

Quality Management Specialist II:

This is the fully qualified journey-level classification. Incumbents are responsible for the more complex and difficult technical assignments and work with greater independence. Incumbents are expected to have an excellent understanding of functions within the assigned HHSA Division and be highly skilled in all aspects. The incumbent will assist in guiding subordinates and will work with professional and technical subordinates assigned to specific programs. Incumbents are expected to be subject matter experts. This position is distinguished by lead responsibilities and level of skill and expertise.

Example of Duties

The following duties are typical for this classification. Incumbents may not perform all of the duties listed and/or may be required to perform additional or different duties from those set forth below to address business needs and changing business practices.

Assists in the design, implementation, and monitoring of quality assurance programs and policies to ensure compliance with federal, state, and local regulations.
Develops and delivers training programs to enhance staff understanding of quality assurance principles and compliance requirements.
Collects, analyses, and reports on data related to service delivery outcomes and process improvements.
Maintains documentation of complaints and grievances.
Reports outcomes and other data to the State as required by contract, law or regulations.
Monitors compliance with response timelines for access, treatment authorization requests and payment.
Develops, updates and monitors the cultural competency plan.
Monitors progress and develops reports required by the annual Quality Management Work plan.
Implements utilization review and quality assurance reviews; coordinates Quality Improvement Committee.
Serves on local and state committees or task forces.
Monitors agreements and contracts with providers as assigned.
Initiates, develop and revise written policies and procedures for quality management and compliance programs.
Participates in audits, reviews, and investigations of program operations and client services to ensure compliance with regulatory requirements.
Works closely with managers in developing program policies which meet federal, state, and local government requirements.
Maintains up-to-date knowledge of relevant laws, regulations, and best practices in quality management and behavioral health.
Attends relevant state and regional meetings.

Quality Management Specialist II

The Quality Management Specialist II performs the above duties but may be assigned more complex and difficult duties with limited supervision and direction.
Reviews and approves Treatment Authorization Requests (TARs) to assess eligibility criteria and ensure payment approval.
Authorizes 24-hour notifications for inpatient hospital placements.
Conducts concurrent reviews of placements to ensure compliance with established guidelines and best practices.
Reviews and signs off on documentation related to the progress and assessment notes of registered interns and student interns.
Provides oversight and ensuring compliance with the Peer Specialist documentation and program requirements.
Monitors charts for adherence to compliance standards, with an emphasis on preventing Fraud, Waste, and Abuse.
Reviews and approves diagnoses on 5150 evaluations and providing ongoing oversight of 5150 and crisis management protocols, when assigned to the Behavioral Health Division.
Conducts training sessions for clinical staff on new Behavioral Health Integration Notices (BHINs) and offering continuous support and guidance to all clinical personnel, when assigned to the Behavioral Health Division.

Minimum Qualifications

Knowledge of:

Behavioral health systems and related legislation.
Program planning, evaluation, needs assessment and quality review principles.
Federal, state, and local guidelines for utilization review and compliance.
Social Drivers of Health (e.g., housing, education, income, transportation, food security, and their influence on behavioral health outcomes and service delivery, as well as strategies for addressing these determinants.

Ability to:

Plan, organize, and coordinate program development and performance monitoring.
Develop and interpret policies, procedures, and regulations.
Community effectively and prepare clear, logical reports.
Build and maintain relationships with stakeholders.

EDUCATION AND EXPERIENCE:

Quality Management Specialist I

Option 1

A bachelor’s degree from an accredited college or university in public health, social work, behavioral health, or other health related field, AND a minimum of one (1) year of experience in quality management, compliance, or a behavioral health setting.

Option 2

An associate’s degree or equivalent from an accredited institution AND three (3) years of experience in quality management, compliance, behavioral health, public health, social work or other health related fields.

Option 3

A high school diploma or GED and five (5) years of experience in behavioral health, social services, public health, or health related fields, with demonstrated expertise in process improvement or regulatory compliance.

Quality Management Specialist II

In addition to the above, Licensure in California as a Licensed Clinical Social Worker (LCSW), Marriage and Family therapist (MFT), or related California license is required.

Job Type: Full-time

Pay: $35.00 – $50.00 per hour

Benefits:

401(k)
401(k) matching
Dental insurance
Health insurance
Paid time off
Vision insurance

Schedule:

8 hour shift
Day shift
Monday to Friday

Application Question(s):

Do you have any experience working on Government or Federal projects? If yes, please mention the project name.
Are you a U.S. citizen?
Are you a green card holder?
What is your current location?
What is your email address/ID?
What is your expected hourly pay rate?

Experience:

federal, county or government work : 3 years (Preferred)
Behavioral health systems: 3 years (Preferred)
Social Drivers of Health: 3 years (Preferred)

Ability to Commute:

San Andreas, CA 95249 (Preferred)

Ability to Relocate:

San Andreas, CA 95249: Relocate before starting work (Preferred)

Work Location: In person

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Title: Quality Control Specialist

Company: Collins Pine Company

Location: Lakeview, OR

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