Quality & Compliance Lead — Health Services Data

PRC; San Francisco (CA); On-site; USD 65,000 - 90,000; Full time

Benefits offered by this job

Medical, dental, and vision insurance

403(b) retirement plan

Paid time off

Professional development opportunities

Job summary

PRC Baker Places in San Francisco is a nonprofit dedicated to serving the community with legal advocacy, workforce development, financial services, and residential treatment. The Quality Management Specialist supports data collection, audits, HIPAA compliance, and reporting to drive quality clinical services across programs.

The role requires strong data skills, familiarity with EMR systems (Avatar/EPIC), and knowledge of Medi-Cal/ASAM documentation, with a willingness to work non-traditional

Qualifications

• Bachelor of Science with two years' experience preferred, Four years of experience may be substituted for the educational requirement.
• Experience in health information technology and strong computer skills required.
• Experience in data collection and assessment.
• Good analytical and organizational skills
• Familiar with electronic medical records systems/EMRS (ie: Avatar/EPIC) and Microsoft Office platform.
• Knowledgeable about California Mental Health Medi-Cal residential and Specialty Mental Health-Outpatient billable services and documentation including, diagnosis and medical necessity justification is preferred.
• Knowledgeable about California Drug Medi-Cal residential substance use disorder billable services and documentation, including ASAM criteria and levels of care designation, diagnosis and medical necessity justification is preferred
• MH and Drug Medi-Cal audit experience via EMRS or hard copy chart.
• Willingness to work non-traditional hours as the job necessitates
• Must maintain annual TB clearance and First Aid /CPR Certification.
• Exhibit exemplary customer service, compassion, and care in the execution of all duties and interactions.

Responsibilities

• Provide data entry of QM data into the quality database.
• Develops forms and protocols within the QM Department to gather real time clinical record information.
• Aid in the creation and development of various clinical data reports and perform data entry.
• Audit clinical record data on a regular basis to ensure data integrity, quality, identify data anomalies, and enter results into databases.
• Aggregate audit data received, identifying all documentation weaknesses and risk trends, as they present, that have potential to impact licensing, regulatory or contractual compliance
• Identify and report data entry errors and omissions immediately to Director of QM.
• Ensure clinical record confidentiality and HIPAA compliance
• Track clinical record documentation and audit results submitted by Quality Assurance Specialists.
• Collect, compile, and analyze data from the QM team to measure and report on provider and program clinical record documentation and other record related performance.
• Provide data and other related materials for clinical auditsfor compliance reporting and internal data tracking/agency evaluation needs
• Create monthly reports for the Director of Quality Management and quarterly reports for the Quality Management Committee.
• Train and update program management staff quarterly on data collection activities.
• Other duties as assigned.
• Promote agency mission, purpose, and values in relationships with internal and external partners.

Skills

Data entry

Data analysis

HIPAA compliance

Microsoft Office

Customer service

Education

Bachelor of Science

Experience substitution allowed

Tools

Avatar/EPIC EMR

Job description

PRC Baker Places in San Francisco is a nonprofit dedicated to serving the community with legal advocacy, workforce development, financial services, and residential treatment. The Quality Management Specialist supports data collection, audits, HIPAA compliance, and reporting to drive quality clinical services across programs.

The role requires strong data skills, familiarity with EMR systems (Avatar/EPIC), and knowledge of Medi-Cal/ASAM documentation, with a willingness to work non-traditional