Quality Management Auditor Specialist

Dentonmhmr; Denton (TX); On-site; USD 42,000 - 64,000; Full time

Job summary

Dentonmhmr seeks an entry-level Quality Management Auditor Specialist to conduct inspections and QA reviews in alignment with federal, state, and local guidelines. You will support data collection, analysis, and reporting to monitor consumer care quality and identify improvement opportunities.

Under the QM PM, you will work with limited supervision, ensuring timely documentation, adherence to policies, and effective communication with providers and stakeholders.

Qualifications

• Bachelor's degree required; significant QA/audit experience in LMHA may substitute.
• Proficiency in Windows MS Office (Word, Excel, Access), email and internet.
• QMHP preferred with major in social/behavioral/health/human services.
• Three years QA experience in HHSC service system preferred.

Responsibilities

• Completes mental health medical record reviews and participates in self-assessment activities.
• Compiles deficiency reports and notifies service providers of non-compliant events.
• Enters results into a monthly worksheet and reports trends as needed.
• Develops quality indicators for review on each service type.
• Reviews established indicators to ensure current relevance.
• Attends QM team meetings and signs in to acknowledge participation.
• Performs trend analysis and submits reports to supervisor.
• Conducts quality of care investigations and flags risk areas.

Skills

Texas regulations knowledge

Field inspection methods

Quality control

Data collection & analysis

Documentation & reporting

Education

Bachelor's degree

QMHP preferred

3 years QA experience in HHSC

Tools

MS Office

Excel

Access

Job description

Under the direction of the Quality Management Program Manager (QM PM) and within federal, state and local guidelines performs entry-level inspection work. Work involves conducting inspections and quality assurance reviews to ensure compliance with laws, regulations, and agency policies.

The Quality Management Auditor Specialist assists in the implementation of an on-going quality assurance program designed to objectively and systematically monitor and evaluates the quality and appropriateness of consumer care through documentation reviews, pursues opportunities to improve consumer care and resolve problems. The Quality Management Auditor Specialist performs technical work to assist in data collection, tabulation, analysis and report writing for quality management in analysis of performance measures, and other research related activities to develop an effective system of oversight for community services. Works under moderate supervision, with limited latitude for the use of initiative and independent judgment.

Education, Training, and Experience

• A bachelor's degree from an accredited college or university is required; significant experience auditing or conducting quality assurance functions in a Local Mental Health Authority (LMHA) can be considered in lieu of a degree.
• Working knowledge and ability with Windows based Microsoft Office Word, Excel, Access software, E-mail and internet use or knowledge required.
• Major in social, behavioral, health or human services to qualify as a Qualified Mental Health Professional (QMHP) preferred.
• Three years quality assurance experience in HHSC service system preferred.

Registration, Certification, Licensure, and Other Qualifications

• Must have and maintain a background and criminal history free from any disqualifying offenses as outlined by the Texas Administrative Code (TAC) and the Health and Human Services Commission (HHSC).
• Must possess and maintain a valid driver's license and automobile insurance.
• Individuals with an out-of-state driver's license must be able to obtain a driver's license in the state of Texas within thirty (30) days.
• Successful completion of all position-specific training within thirty (30) days of employment and ongoing compliance with annual training requirements is required.

Knowledge, Skills, and Abilities

• Knowledge of Texas Laws, codes, and standards related to the area of responsibility; of the principles and methods of field inspection and quality control and of business practices.
• Skills in conducting inspections, in determining proper courses of action, in using instruments and tools necessary to conduct inspections; in using computer based programs and databases and in maintaining records and written reports.
• Ability to prepare reports, to interpret laws and regulations, to gather and analyze data, and to communicate effectively.
• Ability to display regular and reliable (in-person, if required) attendance.
• Understanding and practice of Trauma Informed Care principles.

The following list outlines key responsibilities for the position; however, it is not exhaustive and does not encompass all responsibilities. Additional duties may be assigned as needed.

1. Quality Review Activities

• Completes mental health medical record reviews and participates in self-assessment activities for the Center as assigned.
• Complies deficiency reports and forwards to service provider about non-compliant events.
• Enters results into a monthly worksheet to track trends and makes reports available as needed.
• Assists in the development of quality indicators for review on each service type.
• Assists in the review of established quality indicators on an ongoing basis to assure assessment of current applicable indicators.
• Participates in the annual review of each service type within the mental health service area each fiscal year.
• Submits all requested reports within required and established time frames.
• Performs trend analysis on ongoing quality review findings and submits trend reports to the supervisor as required.
• Completes quality of care investigations as assigned and reports all potential areas of risk exposure to the attention of the QM PM.

2. Policy and Procedure Activities

• Assists in drafting, implementing, and evaluation of Center wide policies and procedures related to quality management.
• Assists in assuring adherence to Center wide policy and procedure as required by standards, regulations and laws.

3. Provider Relation Activities

• Develops and maintains a positive relationship with current providers while carrying out assigned activities.
• Provides technical assistance in the areas of quality management as requested by supervisor and as deemed appropriate based upon relevant review information.
• Exhibits positive representation of the Center throughout all correspondence and communication both within and outside the Center.

4. Attends and participates in all scheduled meetings

• Staff will attend all QM team meetings as scheduled and sign in for meetings to acknowledge their presence and understanding of the topics discussed.
• If a meeting is missed, staff will get with supervisor within one week to review the information.
• Expands professional knowledge through resource materials, periodicals, etc.
• Completes all staff development training as required.
• Perform additional duties as deemed necessary by department supervisor within designated timeframes.