Quality and Compliance Data Specialist (Behavorial Healthcare)

The Quality and Compliance Data Specialist provides a broad range of administrative, facilitation, technical support and data management in the quality and compliance areas within the Organizational Excellence division of CHD. The Specialist will be responsible for the extraction and analysis of identified data utilizing statistical tools and generating visual reports. Contributes to the development, implementation, monitoring, of risk mitigation and continuous quality improvement initiatives. Contributes to the development and monitoring of performance indicators and metrics, collaborates with appropriate programs and departments to collect, analyze, and trend data from multiple reporting systems and sources to identify opportunities to, improve the quality of services, program performance, to minimize risk, increase compliance and enhance safety across divisions and programs. Works in partnership with all staff within and external to the Organizational Excellence (OE).

Essential Responsibilities:

• Evaluates complex data sets and interprets its significance for operational and strategic decision-making.
• Consults with internal stakeholders to develop and define metrics for quality reporting.
• Supports other functions within OE in all project phases from concept to implementation
• Collect data to report on key performance indicators, regulatory requirements, and quality metrics.
• Works with the VP and Managers to develop and actualize the audit plan, identify risks, trends and propose operational changes based on findings.
• Supports CHD compliance through assigned compliance activities and audits to ensure effective documentation, identify compliance risks by coordinating independent reviews and assessments of assigned operational processes, and internal controls for completeness and accuracy
• Conducts audits including but not limited to billing, claims, EHR access, HIPAA privacy, clinical and medical records compliance.
• Pursues effective relationships with others by proactively providing resources, information, advice, and expertise with coworkers and members. Listens to, seeks, and addresses performance feedback; provides mentoring to team members.
• Conducts data extraction, analyses, and presentations to support quality improvement efforts. Creates visualization of data as part of data reporting via MS Excel, Power BI or similar applications.
• Maintains the documentation of all audits and reviews in designated software systems
• Report issues and observations related to audit processes and outcomes; provides information concerning such issues through resolution
• Participate in and make important contributions in committees and working groups
• Conduct investigations regarding significant suspected fraudulent activities within the organization as assigned.
• Validates findings of audits are in compliance with state and federal regulations, internal policy and procedure mandates; and recommends process, procedure, and policy improvements to mitigate against identified risks or gaps in performance.
• Perform other related duties incidental to the work described herein or as assigned.
• Acts in the role of investigator as part of the CHD investigations team.
• Provides and participates in relevant CHD trainings as assigned
• Completes other tasks and projects as assigned and completes tasks within requested timeframes.
• Escalates high-risk issues and trends to appropriate leadership staff for resolutions.

Education:

Bachelor’s degree in Public Health, Statistics, or Healthcare Informatics and at least one year of field experience in a healthcare setting.

Qualifications:

• Experience working in behavioral healthcare not for profit setting preferred
• Experience with advanced analytics, data management, and data visualization tools.
• Experience with statistical analysis
• Project management skills a plus
• Proficient in MS Office
• Skilled in use of Power BI or another data visualization tool
• Advanced Excel Skills
• Strong problem solving & analytical skills
• Excellent verbal and written communication skills in English
• Highly developed ability to interact with diverse groups
• Willing and able to adapt to changes in work environment, procedures, priorities, and job duties
• Excellent customer service skills with appropriate sense of urgency and sensitivity to business needs
• Ability to function well within a cross-functional team setting and independently
• Ability to give and receive feedback and resolve conflict effectively and in a professional manner
• Experience with healthcare data and data integration
• Demonstrated ability to manage time and multiple projects at once in an effective, productive manner
• Demonstrates good judgment in making decisions
• Completes assigned duties and responsibilities in an accurate, timely and efficient manner
• Outstanding skills in data collection, analysis, and presentation
• Must demonstrate integrity, sound judgment and demonstrated leadership skills
• Ability to effectively present information and respond to questions from all levels of internal staff as well as external entities.
• Ability to work collaboratively with staff at all levels and across all departments and programs
• Sensitivity to the needs of the individuals served.
• Must have a valid driver’s license and a working vehicle.

Take advantage of a competitive compensation $55,000-$65,000 annually, earning potential is based on experience. Check out just some of the great benefits CHD has to offer:

• Health Insurance
• Dental Insurance
• Flexible Spending Accounts (FSA)
• Health Fitness & Education Class Discounts
• Employee Wellness Benefits
• CHD is a PSLF qualifier and MA-Repay qualifier
• Paid Major Holidays
• Generous Paid Time Off / Vacation

AT Center for Human Development (CHD) Care Finds a way:

The Center for Human Development (CHD) provides a broad range of high quality, community-oriented human services dedicated to promoting, enhancing, and protecting the dignity and welfare of people in need. At CHD we are celebrating differences, inclusion is not just a policy- it is a daily practice. Multicultural, multilingual, and fluent in sign language, CHD is a reflection of those we serve.

CONNECT WITH OUR TEAM TODAY!

If this sounds like the right job for you, do not wait - apply today to join our team. We look forward to hearing from you!