Quality Management Specialist - Austin, United States - Health & Human Services Comm

Health & Human Services Comm

Verified Company

Austin, United States

2 weeks ago

Posted by:

Mark Lane

beBee recruiter

Description

Program Specialist V

This position is eligible for 100% telework consistent with the HHS telework policy. Travel to a regional HHS office for meetings and pick up or repair of HHSissued equipment, may be required.
The HHSC Behavioral Health Services Quality Management (QM) Specialist works under the supervision of the Quality Management Manager, or his/her designee, performing complex, advanced consultative and technical work requiring specialized knowledge in the evaluation and continuous improvement of services, programs and organizations. Works as a team member. Plans, develops, implements and functions as team member/leader for onsite & desk reviews and studies to determine service quality and compliance with contracts, grants, laws, regulations, policies, and procedures to continuously improve the quality and efficacy of services. Evaluates the services delivered to consumers and business functions for managing care, ensures the effective communication of findings to customers, evaluates providers' plans of correction/improvement and conducts followup to determine if improvements have been made and maintained. Conducts highly advanced assessment of multifaceted compliance information from within the division, across the agency and from auditing information to determine monitoring needs and steps to bring a contractor into compliance. Leads, participates and contributes in crossfunctional teams/workgroups, trainings and interagency and intraagency work. Performs Lead role in Behavioral Health Services (BHS) and unit initiative implementation. Designs, develops and implements effective policies and protocols for evaluation and monitoring of business functions and service delivery; to include designing, collecting, synthesizing, analyzing and evaluating performance measures and other data. Work includes developing performance reports, conducting data analysis to evaluate the effectiveness of systems, standards, and policies. Collects, analyzes and performs complex interpretation of data to evaluate performance, utilization, compliance with laws, regulations, policies, procedures, contractual performance indicators, best practices, organizational risks and service delivery gaps and make recommendations to management and providers. Studies and analyzes operations and prepares reports of findings and recommendations, prepares administrative reports, studies, and specialized research projects. Participates in activities such as risk assessment to determine priorities for the evaluation and the development of standards and procedures for major departmental initiatives. Performs complex analysis and interpretation of data to identify trends and best practices, makes recommendations to management and providers. Produces professional, accurate communications, provides technical support and training related to compliance, quality management and identification of best practices, makes presentations and responds to inquiries from providers and the community. Works under limited supervision with considerable latitude for the use of initiative and independent judgment and sometimes supervises the work of others.

Essential Job Functions:

EJF1.

Plans, implements and functions as Review leader for onsite, desk, focused and statewide reviews to assess service quality and compliance with Behavioral Health contracts, grants, applicable Federal and state laws, regulations, policies, and procedures; and prepares the required reports or responses as appropriate.

Maintains positive work relationships with internal and external stakeholders. Evaluates organizational systems, business functions and the quality and efficacy of services.

Evaluates plans of correction/improvement and conducts follow-up to determine if improvements have been made and are maintained, and works with contract manager/project officer to recommend sanctions and penalties.

(40%)

EJF 2. Develops and implements policy and protocols for evaluation of business functions, service delivery and outcomes; employs quality management methods to collect, synthesize, analyze and use data in the process of facilitating continuous improvement within organizations providing Behavioral Health services. Conducts studies and specialized research projects, represents Quality Management Unit on workgroups to develop standards and processes for new agency initiatives within a team model. (15%)
EJF 3. Participates in activities such as risk assessment to determine priorities for the deployment of oversight resources; performs analysis and interpretation of data to identify trends and best practices. Uses data and knowledge of the system to make recommendations to management and providers to improve the quality or efficiency of processes. Participates in performance measurement and identification of providers at risk of noncompliance with the contract or delivering poor quality Behavioral Health services. (15%)
EJF 5. Provides consultation and technical assis