Quality Improvement Supervisor I/II

  • SAN BENITO COUNTY, CA
  • Hollister, California
  • May 16, 2019
Full Time Administration and Management Administrative Analysis and Research Human and Social Services
  • Salary: $37.49 - $55.39 Hourly

Job Description

THIS IS A CONTINUOUS POST AND MAY BE CLOSED AT ANY TIME.

DEFINITION - QUALITY IMPROVEMENT SUPERVISOR I
Under direction of the Behavioral Health Director or Management Designee, the Quality Improvement Supervisor-I plans, coordinates and evaluates a variety of service delivery systems and program activities within the Quality Improvement Program of the County Behavioral Health Department. The Quality Improvement Supervisor-I provides support in the evaluation of the work produced by professional, paraprofessional staff and other support personnel. The Quality Improvement Supervisor-I may plan for and perform a variety of administrative work functions associated with ensuring appropriate utilization of the type and quantities of behavioral health services.

DEFINITION - QUALITY IMPROVEMENT SUPERVISOR II
Under general direction of the Director of Behavioral Health, plans, organizes, manages, evaluates and supervises the activities that ensure the quality of client care and over-all quality/effectiveness of major programs within the County Behavioral Health Department; assigns and evaluates the work of multidisciplinary professional and paraprofessional staff and other support personnel, may plan and provide a variety of direct client behavioral health services, performs a variety of administrative work functions associated with ensuring fiscally sound utilization of behavioral health services; serves a primary role in the completion of the departments Performance Improvement Projects; serves as the departments Compliance Officer; serves as a liaison for the department with contracted direct service providers, community, regional, or State agencies

DISTINGUISHING CHARACTERISTICS - QUALITY IMPROVEMENT SUPERVISOR I
This is an entry level, middle management position (MEG) position in the Quality Improvement Supervisor series that works in a support role for the implementation of the Quality Improvement functions required in the operation of the Behavioral Health Department. The Quality Improvement Supervisor-I provides assistance with the administration of the quality improvement and compliance plan of a major department with multiple programs that include mental health and substance abuse branches. The Quality Improvement Supervisor-I assists in maintaining the quality of both staff and program performance and workload standards. The primary focus is to ensure the that the work produced within the Behavioral Health Department is in compliance with state and federal laws and regulations, utilization review and overall services and programs quality improvement in Behavioral Health.

The Quality Improvement Supervisor-I is distinguished from the Quality Improvement Supervisor-II, as an entry level position in the series and does not assume overall management authority over the Quality Improvement activities and operations within the Behavioral Health Quality Improvement Program. As the Quality Improvement Supervisor-I is the first level in the Quality Improvement Supervisor series, an individual that occupies this position is expected to have the aptitude to learn and implement under direction, the regulations and laws to maintain the Behavioral Health Departments compliance. Additionally the Quality Improvement Supervisor-I in the support role should have the ability to perform tasks as delegated that require the use of Excel, basic math calculations and the construction of reports requiring the assembling of and organization and interpretation of behavioral health services data utilized for program evaluation and analysis.

DISTINGUISHING CHARACTERISTICS - QUALITY IMPROVEMENT SUPERVISOR II
This is middle level management position with primary responsibility for the administration of the quality improvement and compliance plans of a major department with multiple programs that include mental health and substance abuse branches. Incumbents are responsible for maintaining the quality of both staff and program performance and workload standards. This classification requires strong management and communication skills as well as problem solving skills and the ability to participate effectively in decision-making processes. This classification also requires a high degree of professional knowledge in the areas of mental health and substance abuse treatment/support services, federal and state laws and regulations related to MediCal and Medicare reimbursement and program operations.

REPORTS TO - QUALITY IMPROVEMENT SUPERVISOR I
Behavioral Health Director or Management Designee

REPORTS TO - QUALITY IMPROVEMENT SUPERVISOR II
Director of Behavioral Health

CLASSIFICATIONS SUPERVISED - QUALITY IMPROVEMENT SUPERVISOR I/II
This classification has no direct supervisor responsibility of specifically assigned staff, however the responsibilities of the position requires review and analysis of the work produced by professional level, paraprofessional, other support personnel and the service programs within which these staff provide services.

PHYSICAL REQUIREMENTS
Sit for extended periods; frequently stand and walk; normal manual dexterity and eye-hand coordination; lift and move objects weighing up to 25 lbs.; corrected hearing and vision to normal range; verbal communication; use of office equipment, including computer, telephone, calculator, copiers, and FAX.

TYPICAL WORKING CONDITIONS
Work is performed in an office, clinic, homes, school, or community environments; work is performed with people who may exhibit unstable and potentially violent behavior; continuous contact with other staff and the public.

Examples Of Essential Duties:
QUALITY IMPROVEMENT SUPERVISOR I
(The following is used as a partial description and does not exemplify the full scope of all duties required.)
  • Supports in the review of client admission data and clinical documentation to ensure compliance with County and State regulations and policies relating to medical necessity and case documentation
  • Reviews case records for the inclusion of required documentation components.
  • Supports in the development of training for staff and contract providers on regulations, policies and procedures, code of conduct, documentation requirements, etc.
  • Participates with department staff in utilization review and quality improvement meetings.
  • Supports with the evaluation of financial status of inpatients at contractor inpatient facilities to identify appropriate lengths of stay, medical necessity and payer sources.
  • Supports with the posting and reconciliation of all payments from all payer sources for inpatient physician services and bed day charges.
  • Records MediCal and Medicare payments, cutbacks and denials.
  • Prepares or supports in the preparation of comprehensive reports related to program operations and activities.
  • Works on the design, implementation and completion of the departments Performance Improvement Projects.
  • Support the responsibilities of compliance as identified in the department's Compliance and Quality Management Plans.
  • Ensures the adherence to and fulfillment of the responsibilities of the department as described in the department's Annual Quality Improvement Plan.
  • Responds to requests for information and assistance.
  • Under supervision and with direction assists in the preparation for various state and federal program audits to ensure department compliance with MediCal and Medicare regulations.
  • Supports with monitoring overall activities of assigned programs/functions, including contracted service providers/programs, methods and procedures for effectiveness and consistency with program goals and objectives.
  • Supports in filing MediCal updates.
  • Operates a computer and updates files, records.
  • Other duties as assigned
QUALITY IMPROVEMENT SUPERVISOR II
(The following is used as a partial description and is not restrictive as to duties required.)
  • Reviews client admission data and clinical documentation to ensure compliance with County and State regulations and policies relating to medical necessity and case documentation: when appropriate interviews clients, significant others, and consults with outpatient professional staff, and contract provider staff regarding client diagnoses, medical necessity, length of treatment and case documentation.
  • Reviews case records and assesses for appropriate levels of care, aftercare and discharge planning.
  • Represents the County in disputes with contract providers over appropriateness of treatment plans and length of stay in care.
  • Advocates on behalf of the County with contract provider staff for appropriate client care.
  • Provides training for professional, paraprofessional and contract provider staff on information about utilization and documentation requirements.
  • Facilitates and participates with department staff in utilization review and quality improvement meetings.
  • Evaluates financial status of inpatients at contactor inpatient facilities to identify payer sources; posts and reconciles all payments from all payer sources for inpatient physician services and bed day charges; records MediCal and Medicare payments, cutbacks and denials.
  • Prepares comprehensive reports related to program operations and activities
  • Works in a primary staff role in fulfilling the responsibilities for the design, implementation and completion of the departments Performance Improvement Projects
  • Fulfills the responsibilities of the Compliance Officer as identified in the departments Compliance Plan
  • Ensures the adherence to and fulfillment of the responsibilities of the department as described in the department's Annual Quality Improvement Plan
  • Responds to requests for information and assistance
  • Assists in the preparation for and participates in various state and federal program audits to ensure department compliance with MediCal and Medicare regulations
  • Monitors and evaluates overall activities of assigned programs/functions, including contracted service providers/programs, methods and procedures for effectiveness and consistency with program goals and objectives, recommending and implementing upon Director approval changes in program, policies, and procedures as necessary.
  • Files MediCal updates
  • Operates a computer and updates files, records


Typical Qualifications:
Any combination of training and experience which would likely provide the required knowledge and abilities is qualifying. A typical way to obtain the required knowledge and abilities would be:

QUALITY IMPROVEMENT SUPERVISOR I
Professional experience in a multidisciplinary community based program which includes experience in quality management, program evaluation, quality improvement and /or experience in the production of reports requiring basic math, assembly of data and work with Excel.

AND

A Masters or Bachelor's degree from an accredited college or university with major course works in social work, human services, clinical psychology, nursing, public administration, or a degree in another similar area of subject matter as those previously identified.

License or Certificate:
Possession of one of the following issued by the State of California is desirable, but not essential:
  • Pre-licensed or Licensed Clinical Psychologist
  • Pre-registered or Registered Nurse
  • Pre-licensed or Licensed Clinical Social Worker
  • Pre - licensed or licensed Marriage Family and Child Counselor

QUALITY IMPROVEMENT SUPERVISOR II
At least three years of licensed professional experience in a multidisciplinary Behavioral Health program which includes experience in administrative management and /or clinical supervision that demonstrates possession of the knowledge and abilities.

AND

Completion of academic coursework and training as defined in Title IX for the California Administrative Code in one of the following:
  1. Ph.D. in clinical psychology from an accredited school;
  2. Master's degree in Social Work from an accredited school of social work;
  3. Master's degree in Marriage, Family and Child Counseling, Psychology, or Counseling from an accredited school.
  4. Registered Nurse, meaning a person licensed as a registered by the California Board of Registered Nursing.
SPECIAL REQUIREMENTS FOR QUALITY IMPROVEMENT II
Special Requirements:
Possession of a valid California class C driver license.
Possession of one of the following licenses issued by the State of California: Clinical Psychologist; Registered Nurse; Clinical Social Worker; or Marriage Family and Child Counselor.

Supplemental Information:
QUALITY IMPROVEMENT SUPERVISOR I
Knowledge of:
  • Previous Knowledge of Quality review/quality assessment principles, practices, methods and techniques are desirable but not essential for the Quality Improvement Supervisor-I entry level but the candidate should possess the aptitude to understand, learn and apply the laws and regulations as related to the operations of a Behavioral Health Department.
  • Cultural, socio-economic and language factors that affect service delivery to ethnic populations
  • Basic training and employee development principles and practices
  • Basic mathematics and basic computer applications and techniques
Ability to:
  • Work collaboratively with program managers and staff
  • Promote and support quality management initiatives and operating systems
  • Collect, interpret and evaluate data
  • Interpret complex regulations, laws and guidelines, and policies and procedures governing behavioral health programs and services
  • Prepare concise, logical oral and written reports and explain policies, procedures and recommendations
  • Communicate effectively both orally and in writing
  • Prepare and maintain accurate records
  • Operate standard office equipment, utilize various software programs relevant to the responsibilities of the position
  • Operate a motor vehicle; assist in the establishment of program goals and objectives and evaluate their attainment, train, evaluate and motivate staff
QUALITY IMPROVEMENT SUPERVISOR II
Knowledge of:
  • Quality review/quality assessment principles, practices, methods and techniques
  • Pertinent laws and regulations regarding health and social service programs, including guidelines pertaining to reimbursement of health care services
  • Federal, state and county regulations and policies pertaining to utilization review
  • Laws and regulations pertaining to client's legal rights
  • Basic pharmacology and and the utilization of prescription drugs for treatment: Methods and procedures of admissions, discharges, and client care in outpatient and acute care psychiatric settings
  • Principles, practices, and techniques of psychotherapy and psychiatric casework and substance abuse treatment
  • Social aspects, attitudes, characteristics and behaviors of mental illness, emotional disturbances and addiction to drugs and alcohol
  • Current developments in the field of Mental Health and Substance Abuse Treatment
  • Community resources available to mental health and substance abuse programs
  • Cultural, socio-economic and language factors that affect service delivery to ethnic populations
  • Basic training and employee development principles and practices
  • Basic mathematics and basic computer applications and techniques.
Ability to:
  • Review and interpret healthcare documentation, including interpretation of clinical data and medical terminology pertaining to diagnosis, treatment and medication
  • Ascertain facts through examination of records
  • Collect, interpret and evaluate data
  • Interpret complex regulations, laws and guidelines, formulate policies and procedures, rationalize and project consequences of decisions, and /or recommendations
  • Establish and maintain effective relations with clients, the general public, contract providers and personnel at all organizational levels
  • Prepare concise, logical oral and written reports and explain policies, procedures and recommendations
  • Communicate effectively both orally and in writing
  • Prepare and maintain accurate records
  • Operate standard office equipment, utilize various software programs relevant to the responsibilities of the position
  • Operate a motor vehicle; assist in the establishment of program goals and objectives and evaluate their attainment, train, evaluate and motivate professional and support staff.
In accordance with California Government Code section 3100, et., seq., all County of San Benito employees are considered disaster service workers who may be required to report for duty, or remain on duty to address disaster service activities in the event of an emergency or disaster and are required to undertake an applicable loyalty oath.


Closing Date/Time: Continuous