- Professional
- Office in Memphis
GENERAL FUNCTION: The Compliance and Quality Analysts will assist the Vice President of Compliance and Special Projects in ensuring licensure requirements are met, maintaining accreditation, and monitoring quality and outcomes of all clinical programs.
SUPERVISORY RESPONSIBILITY: None
IMMEDIATE SUPERVISOR: This position will report to the Vice President of Compliance and Special Projects.
QUALIFICATIONS: KNOWLEDGE AND REQUIRED TRAINING:
- Healthcare related graduate degree preferred (equivalent experience may be considered).
- Minimum of three years health care practice experience with healthcare software experience.
- Knowledge of reimbursement systems; federal, state, and payer-specific regulations and policies pertaining to mental health documentation, coding, and billing.
- Strong interpersonal and problem-solving skills.
- Excellent written and oral communication skills.
- Places a high value on ethical standards and treating others with dignity and respect.
DUTIES AND RESPONSIBILITIES:
External Requirements
• Maintain working understanding and compliance with CARF, CCBHC, State licensure, CMS, OIG, and contract requirements for the agency.
• Attend TAMHO Compliance and Quality Committee meetings as requested.
Internal Requirements
• Operate from and adhere to the Alliance Strategic Plan, Compliance Plan, and Quality Plan.
• Serve on any internal committees related to compliance and quality, as requested. This may include policy committee, incident review committee, and others that are developed.
• Assist with creating agency policies. Standard Operating Procedures must also be developed for policies created. Supervisors and staff must be trained on current and new policies developed.
Audits, Incidents, and Complaints
Complete agency-wide Quality Audits (QAs). QAs will be multi-faceted and will include chart reviews, supervisor interaction, staff feedback, and listening to phone call recordings. Analyze and report on internal audits.
• Participate in all external audits as requested. Audits may include but are not limited to CARF, MCOs, licensure, and THL. Analyze and report on external audits.
• Complete and analyze Incident Reviews agency wide. Incident Reviews must be completed within 72 hours of receipt unless it is a reportable incident. Reportable incidents must be completed and reported to the State within 24 hours of receipt.
• Review client and shareholder complaints. Analyze and report on any trends.
Clinical Training, Onboarding, and Internships
• Complete agency-wide and staff-specific training that may include but is not limited to Title VI, SafeClinch, Therapeutic Options, Customer Service, and safety trainings.
• Work collaboratively with all Supervisors to provide site or staff specific training. Trainings should be data-driven and documented consistently.
• Complete clinical onboarding for Crisis, Outpatient, and Housing staff. This will include completing trainings, assigning trainers/mentors, reviewing and filing all training documentation.
• Oversee the clinical internship process for Crisis, Outpatient, and Housing. This will include corresponding with candidates and HR, ensuring all required documentation is received and accurate, assigning interns to a Supervisor, monitoring internship experience, and job placement when relevant.
Data, Outcomes, and Reporting
• Understand and monitor overall outcomes and trends for all clients served through consistent data review. Report on these outcomes and trends, as requested.
• Monitor completion of and analyze client satisfaction surveys. These surveys may include NOMs, TOMs, MHSIPs and must be reported to TAMHO regularly.
• Participate in the development of quarterly and annual reports to share with employees and external shareholders.
Other
• Adhere to Alliance standards of professionalism by being punctual and dependable, neat and professional in appearance, maintaining an enthusiastic approach to completing assignments, standing out as a positive role model for others, utilizing appropriate methods to cope with stress, accepting constructive criticism and integrating suggestions in effective ways, and working with others to promote cooperation to accomplish the agency mission.
• Other duties as assigned.
PERSONAL RELATIONSHIPS:
In order to appropriately accomplish his/her duties, the person occupying this position must maintain effective working relationships with Alliance leadership team, Supervisors, employees, and other shareholders.
