Overview
Quality Reporting & Accreditation Specialist Jobs in Philadelphia, USA at Community Behavioral Health.
The Quality Reporting and Accreditation Specialist will serve as the primary project manager for CBH’s effort to obtain and maintain National Committee for Quality Assurance (NCQA) accreditation Managed Behavioral Health Organization Accreditation, Certified Review Entity Certification, and Health Choices Reporting. The Quality Reporting and Accreditation Specialist will also assist the Director of Quality Improvement in the monitoring, documenting, and reporting of quality management activities.
Essential Functions:
- Serves as project manager for coordinating and collaborating with accreditation and certification entities and the Office of Mental Health and Substance Abuse Services to ensure compliance with accreditation, certification, and Health Choices requirements. Prepares CBH for accreditation, certification, and Health Choices submissions and reviews.
- Develops tools that assist in determining exposure to quality risks and identifies opportunities to manage and mitigate those risks.
- Compiles information for quality improvement and monitoring activities, and accreditation/certification for internal use and external audits, and maintains relevant records.
- Works with internal departments to develop metrics to accomplish program objectives and monitors action plans relating to improving compliance with accreditation/certification requirements and quality improvement activities.
- Makes recommendations to CBH Officers and Quality Improvement Committee for improvements or remediation to ensure compliance to accreditation, certification, and Health Choices requirements.
- Assist in assuring both internal and external program integrity by being alert to and reporting suspected instances of provider and employee fraud, waste, or abuse.
- Responsible for coordinating messaging of quality improvement and monitoring activities to internal and external stakeholders.
Education:
- Education:
Master’s degree in behavioral health, healthcare, public administration, or social sciences.
- License/Certification (if applicable):
Certified Professional in Healthcare Quality (CPHQ) preferred; CPHQ Required within 1 year of hire; - Project Management Professional (PMP) certification is preferred.
- Relevant
Work Experience:
Minimum of 3 years post-graduate experience.
Skills:
- Mid to high level proficiency with Microsoft Office applications
- Excellent written and verbal communication skills
- Knowledge of Health Choices regulations and requirements
- Knowledge of NCQA requirements
- Detail-oriented and highly organized
- Knowledge of quality management, assurance, and improvement principles
- Ability to work effectively with all levels of staff
- Ability to manage ongoing projects and prioritize appropriately to meet deadlines
CBH is a dynamic organization dedicated to providing access to high-quality, accountable care to improve the health and mental wellness of our members. CBH offers a robust compensation and benefits package, including:
- Family Planning, Fertility, Adoption Benefits
- 403B Retirement Plan
- PTO Days/Sick Days
- Wellness Program
- Employee Assistance Program
- Health, Dental, Vision Insurance
- Medical, Prescription Drug Insurance
- Tuition Reimbursement
- Commuter Benefits
- Flexible Spending
Core Competencies:
- Teamwork and Collaboration: Build and sustain relationships with co-workers and stakeholders and support efforts and deliverables. Encourage unity and help remove barriers to productivity and success.
- Respect: Treat each other and our members and stakeholders with respect and sensitivity, recognizing the importance of diversity.
- Member Centric: Focus on the needs of our members by providing value-added services, promoting strong relationships and going beyond basic expectations to achieve the best possible outcomes.
- Honesty and Integrity: Be open and honest in all we do. Maintain the highest level of integrity at all times.
- Commitment to Service Excellence: Challenge ourselves to be forward-thinking and committed to providing total member and stakeholder satisfaction, first-in-class service and high quality, innovative programs.
- Compassion and Empathy: Demonstrate a deep appreciation for another’s situation and point of view. Pay attention to emotional cues, listen…
Title: Quality Reporting & Accreditation Specialist
Company: Community Behavioral Health.
Location: Philadelphia, USA
Category:
