Quality & Compliance Specialist

PRC Baker Places; San Francisco (CA); On-site; USD 70,000 - 75,000; Full time

Benefits offered by this job

Medical, dental, and vision insurance

403(b) retirement plan

Job summary

PRC Baker Places in San Francisco seeks a Quality & Compliance Specialist to ensure high-quality clinical services while maintaining regulatory compliance. You will collect data from clinical records, develop QM forms, audit data, and prepare routine reports for the Director of Quality Management.

This is a full-time role requiring attention to detail and ability to work with cross-functional teams in a nonprofit healthcare setting.

Qualifications

• Bachelor of Science with two years’ experience preferred, four years may substitute.
• Experience in health information technology and strong computer skills required.
• Experience in data collection and assessment.
• Good analytical and organizational skills.
• Familiar with EMRs (Avatar/EPIC) and Microsoft Office.
• Knowledge of California Mental Health Medi-Cal billing and documentation is preferred.
• MH and Drug Medi-Cal audit experience via EMRS or hard copy chart.

Responsibilities

• Provide data entry of QM data into the quality database.
• Develop forms and protocols within the QM Department to gather real time clinical record information.
• Assist in creation and development of clinical data reports and perform data entry.
• Audit clinical record data to ensure data integrity and enter results into databases.
• Aggregate audit data to identify weaknesses and risk trends affecting licensing or compliance.
• Identify and report data entry errors to the Director of QM.
• Ensure clinical record confidentiality and HIPAA compliance.
• Track clinical record documentation and audit results submitted by QM Specialists.
• Collect and analyze data from the QM team to measure performance.
• Provide data for clinical audits and internal evaluation needs.
• Create monthly and quarterly reports for QM leadership and Committee.
• Train program management staff on data collection quarterly.
• Promote agency mission and values in partnerships.

Skills

Health information technology

Data collection

Data analysis

HIPAA compliance

Analytical skills

Organizational skills

EMR systems (Avatar/EPIC)

Microsoft Office

Non-traditional hours

Education

Bachelor of Science

Tools

Avatar

EPIC

Job description

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 & Compliance Specialist

Salary Range: $70,304.00 To $75,000.00 Annually

PRC Baker Places is a non-profit organization dedicated to serving the San Francisco community through legal advocacy, workforce development, financial services, and residential treatment programs. We support formerly homeless adults living with co-occurring mental health and substance use disorders by providing a continuum of integrated direct care services. All of our programs are grounded in a social rehabilitation philosophy that integrates harm reduction and daily living skills within a safe and supportive environment.

Mission Statement:Our mission is to help people affected by HIV/AIDS, substance use, or mental health issues better realize opportunities by providing integrated legal, social and health services that address the broad range of social risk factors that impact wellness and limit potential.

Values that Guide Us:Accountability, Honesty, Integrity, Diversity & Inclusion, Respect

If you’re passionate about making a real impact in your community, working in a dynamic, inclusive environment, and helping people rebuild their lives, PRC Baker Places is the place for you.

Title: Quality Management Specialist

Facility Type: DOJ/FBI/CDSS Background Clearance Required

Position Overview

Under the direction of the Quality & Compliance Manager, the Quality & Compliance Specialist is part of the Quality Management/QM Department and assists in ensuring that high-quality clinical services are delivered while maintaining compliance with regulating and contracting entities.

Ensures the accurate and timely collection of data from clinical records, identifies opportunities for improvement and areas of non-compliance. Communicates and works collaboratively with the QM Department team, residential program leadership and agency QM Committee members.

Primary Duties and 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.

Minimum 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.

Salary and Benefits:

This is a full-time, non-exempt position. PRC Baker Places offers a competitive salary plus medical, dental, and vision insurance for employees and their eligible spouse/children, as well as short/long-term disability, life insurance, employer-matching contributions to 403(b) retirement, generous paid time-off, and professional development.