Quality Assurance Specialist

Automatic Data Processing, Inc.; Portage (MI); Hybrid; USD 66.000 - 89.000; Vollzeit

Zusammenfassung

Southwest Michigan Behavioral Health is seeking a Quality Assurance Specialist to monitor, collect, review, and report data to meet contractual requirements and support continuous improvement projects across the region.

You will lead external audits, develop action plans, and drive performance improvement initiatives in collaboration with partner organizations, while ensuring compliance with federal and state requirements.

Qualifikationen

• Bachelor's in social work, psychology, organizational psychology, healthcare administration, statistics, or a human services field
• Quality assurance, auditing, and/or project management experience, with a proven record of leading process improvement projects
• Strong skills organizing, analyzing, and presenting information in verbal and written reports
• Excellent interpersonal skills; works well in teams and independently; manages multiple projects and deadlines
• Advanced Microsoft Office 365 skills (Word, Excel, Outlook, Visio, PowerPoint)
• Supports culturally competent, recovery-based, person-centered, and trauma-informed practices

Aufgaben

• Identify quality initiatives that improve regional clinical performance, member outcomes, and access to services
• Help develop the annual Quality Assurance and Performance Improvement Program (QAPIP) Plan and Evaluation; support regional implementation, including KPIs, Performance Improvement Projects, strategic imperatives, and QAPIP goal tracking across departments
• Review critical incidents to determine sentinel event status, support timely root cause analysis, assist with mortality reviews, and analyze quarterly trends for Critical Incident Reporting System submissions
• Lead and coordinate external audits (HSAG, MDHHS, CMHSP site reviews): consult throughout, prepare reports, and manage remediation
• Develop action plans with partners to address performance issues and monitor progress
• Manage the SWMBH survey process, from distribution and collection to communicating outcomes
• Analyze member experience assessments to identify trends in quality, availability, and accessibility of care; recommend, track, and evaluate systemic action steps
• Track and analyze project details; maintain internal systems for projects, audits, and reports
• Report information to external stakeholders per federal, state, and contractual requirements
• Serve as subject matter expert on quality assurance and performance improvement; coach internal and external customers on improvement methods
• Manage multiple audits and initiatives at once, with strong organization and attention to detail
• If staffed by someone with an active clinical license, may join clinical chart reviews and audits of SWMBH providers and CMHSPs

Kenntnisse

Quality assurance

Data analysis

Project management

Reporting skills

MS Office 365

Ausbildung

Bachelor's in social work

Master's degree with licensure (LMSW, LLP, LPC)

Tools

Adobe Acrobat

Tableau

Power BI

EMR systems

Jobbeschreibung

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.

Quality Assurance Specialist

Clinical Quality Administration Full Time Portage, MI, US

2 days ago Requisition ID: 1168

Salary Range: $65,535.00 To $88,665.00 Annually

Are you interested in improving the quality of life for the people in your community? Do you have a passion for ensuring that those with mental health and substance use disorders receive the services they need? Are you looking for a place to work that is committed to the development of staff and matching people to work they love? A place that values a diverse workforce that strives for excellence while maintaining a healthy work/life balance?

Then come join us!

Quality Assurance Specialist

Southwest Michigan Behavioral Health • Quality & Clinical Outcomes • Office/Home

Reports To

Director of Quality

FLSA Status

Exempt

Compensation

Commensurate with experience

THE QUALITY ASSURANCE SPECIALIST OPPORTUNITY

As our Quality Assurance Specialist, you'll monitor and improve the quality of behavioral health services across the region — leading audits, tracking performance data, and driving improvement projects that make a real difference for the people we serve.

WHAT THE QUALITY ASSURANCE SPECIALIST WILL OWN

• External audits (HSAG, MDHHS, CMHSP site reviews) and provider action plans
• QAPIP development, KPIs, and performance improvement projects
• Critical incident and sentinel event review, root cause analysis, and trend reporting
• The SWMBH survey process and member experience analysis
• Subject matter expertise and coaching on quality improvement

WHAT THE QUALITY ASSURANCE SPECIALIST NEEDS TO BRING

• Bachelor's in social work, psychology, healthcare administration, statistics, or a related human services field
• Experience in quality assurance, auditing, and/or project management, with a track record leading improvement projects
• Strong data analysis and reporting skills; advanced Microsoft Office 365

Keep scrolling for the full position details, or jump straight to applying below.

QUALITY ASSURANCE SPECIALIST — FULL POSITION DETAILS

The Quality Assurance Specialist monitors, collects, reviews, and reports data to meet contractual requirements and support continuous improvement projects. The Quality Assurance Specialist monitors internal SWMBH measures and data elements, organizes projects, coordinates external audits, and provides subject matter expertise in business process analysis and performance improvement.

QUALITY ASSURANCE SPECIALIST DUTIES & ESSENTIAL FUNCTIONS

• Identify quality initiatives that improve regional clinical performance, member outcomes, and access to services, in line with federal, state, contractual, and accreditation requirements
• Help develop the annual Quality Assurance and Performance Improvement Program (QAPIP) Plan and Evaluation; support regional implementation, including KPIs, Performance Improvement Projects, strategic imperatives, and QAPIP goal tracking across departments
• Review critical incidents to determine sentinel event status, support timely root cause analysis, assist with mortality reviews, and analyze quarterly trends for Critical Incident Reporting System submissions
• Lead and coordinate external audits (HSAG, MDHHS, CMHSP site reviews): consult throughout, prepare reports, and manage remediation
• Develop action plans with partners to address performance issues and monitor progress
• Manage the SWMBH survey process, from distribution and collection to communicating outcomes
• Analyze member experience assessments to identify trends in quality, availability, and accessibility of care; recommend, track, and evaluate systemic action steps
• Track and analyze project details; maintain internal systems for projects, audits, and reports
• Report information to external stakeholders per federal, state, and contractual requirements
• Serve as subject matter expert on quality assurance and performance improvement; coach internal and external customers on improvement methods
• Manage multiple audits and initiatives at once, with strong organization and attention to detail
• If staffed by someone with an active clinical license, may join clinical chart reviews and audits of SWMBH providers and CMHSPs

QUALITY ASSURANCE SPECIALIST QUALIFICATIONS

Required

• Bachelor's in social work, psychology, organizational psychology, healthcare administration, statistics, or a human services field
• Quality assurance, auditing, and/or project management experience, with a proven record of leading process improvement projects
• Strong skills organizing, analyzing, and presenting information in verbal and written reports
• Excellent interpersonal skills; works well in teams and independently; manages multiple projects and deadlines
• Advanced Microsoft Office 365 skills (Word, Excel, Outlook, Visio, PowerPoint)
• Supports culturally competent, recovery-based, person-centered, and trauma-informed practices

Preferred

• Master's with licensure or certification (LMSW, LLP, LPC)
• Behavioral health experience with Intellectual and Developmental Disabilities, Severe Mental Illness, and/or Serious Emotional Disturbances
• Knowledge of quality management and continuous improvement principles
• Adobe Acrobat, Tableau, Power BI, and electronic medical record experience; life experience with diverse backgrounds and behavioral health issues

WORKING ENVIRONMENT

Office or home environment with frequent sitting, standing, and walking. Occasional travel to CMHSPs or conferences. Occasional lifting up to 20 lbs.