Position Title: Quality Improvement Specialist I, II and II
Department: Management and General
Reports to: Vice President of Quality Improvement, Impact & Analysis
Position Objective and Summary:
The Quality Improvement Specialist coordinates numerous program evaluation, quality improvement and quality assurance functions within UCAN; including monitoring programs for compliance toward quality standards, implementing tools used for program and service evaluation, and organizing data collection and information analysis. The QIS is responsible for collaborating with programs staff to allow open communication and a dialogue to ensure a QI feedback loop is in place. The QIS is a support to each program and is responsible for bringing out the best work of each team member whenever possible.
Essential Functions and Responsibilities:
Best Practices
- Consults and advises UCAN programs on adherence to Council on Accreditation (COA) Standards and other program-specific accreditation standards.
- Develops and manages plans for COA review preparations and maintenance.
- Consults and advises UCAN programs on compliance with Medicaid Rule 132/140 and associated contract obligations.
- Provides technical assistance for the overall Medicaid service and billing process.
- Supports preparation for Medicaid reviews.
- Maintains familiarity with IDCFS Rules & Regulations, as well as other contractual obligations, and acts as a resource to programs in this area.
- Maintains familiarity with ethical standards and mental health law, advising programs in this area.
- Maintains knowledge of current clinical best practices, educating programs in this area.
- Provide leadership in the area of program evaluation by staying abreast of developments in the field.
- Researches current evidenced-based practices, relevant to UCAN programs.
- Assesses programs current practices and use of evidenced-based practices, and advises in this area.
Program Monitoring, Evaluation & Outcomes
- Develops and manages implementation of plans for program evaluation and improvement.
- Designs data collection systems for evaluation, as needed, and oversees data analyses and interpretation of data to make recommendations.
- Works collaboratively with programs to discuss findings and make program improvements.
- Facilitates and leads programs in the development, use, and revision of program plans including a literature review, logic model, outcomes development and measurement plan.
- Maintains a system for development, review and maintenance of program plans.
- Assists with the development of plans for measuring and tracking outcome data.
- Recommends improvements in evaluation questions, outcome measurement, analysis, presentation, and utilization.
- Facilitate and discuss program monitoring and improvement with management teams through the Performance and Quality Improvement (PQI) Meeting with identified programs.
- Adapt individual program PQI processes to be inclusive of required outcomes, best practice standards, agency initiatives, and program goals on an ongoing basis.
Utilization Review
- Contributes to the development of and assists in the maintenance of all quality standards, including service provision and documentation; works with service providers to assure compliance to these standards taking into consideration agency and program needs, as well as COA, Medicaid and other contractual obligations.
- Collaborates with service providers on quality principles and value of meeting/exceeding quality standards; provides training to respective staff on establishing best practices.
- Coordinates Utilization Review processes; completes on-site reviews and provides feedback to workers regularly.
- Analyzes, summarizes and reports on the results of the Utilization Review and prepare quarterly reports to address trends in findings.
- Create action plans with program teams to address deficiencies found in the Utilization Review Quarterly report and monitor results over time to ensure improvements are made.
Data Management
- Runs discrepancy reports to ensure data accuracy.
- Acts as a support to the agency in the use of UCAN’s information management systems, as well as other identified systems.
Customer Satisfaction
- Develops methods for obtaining customer feedback, including surveys, focus groups and interviews.
- Consults with Program Leaders to develop individualized survey questions for obtaining consumer feedback and supports the administration of customer surveys, in collaboration with programs.
- Designs and conducts focus group as needed.
- Analyzes the results of customer feedback and reports results to program staff and other stakeholders.
Collaboration
- Serves as liaison between IT, Development and program to ensure program needs are being met.
- Builds relationships with staff through program management through attending team meetings, providing 1:1 training (when necessary), and consultation to ensure open channels of communication.
- Maintains knowledge of other QI functions in the agency and collaborates on team projects.
- Conducts trainings and provides program education, as identified.
- Serve as Project Manager and coordinate efforts amongst team members when assigned.
Other Duties as Assigned
- Perform any other duties needed to help drive UCAN’s Vision, fulfill its Mission, and abide by its Values.
Professionalism and Work Conduct
- Behaves with integrity, demonstrates high ethical standards, and displays a positive image of UCAN.
- Acts in a professional manner at all times and maintains appropriate boundaries with customers.
- Demonstrates accountability for results and keeps commitments to others.
- Reports to work, meetings, training, and job related activities prepared and as scheduled.
- Demonstrates openness and respect for cultural and socioeconomic characteristics of youth, families and coworkers
- Understands and supports UCAN’s standard of cultural proficiency and strives to meet it.
- Responds to youth and their families, UCAN staff, external monitors, service providers and other stakeholders in a timely manner and ensures follow up to adequately address their needs.
- Performs other related tasks as required or assigned.
Education /Job Experience/Certification:
Quality Improvement Specialist I
- BA/BS in human service field required, Master’s degree in Social Work or related field preferred.
- Minimum 2 years work experience in social service field required.
Special Knowledge and Qualifications:
- Proficient with Microsoft Office applications, particularly in Excel.
- Strong verbal and written communication skills.
- Excellent decision-making and analytical skills, with the ability to resolve problems and correct errors.
- Excellent interpersonal skills, with the ability to exercise discretion and judgment in dealing with colleagues and customers.
- Strong multi-tasking and organizational skills, with the ability manage numerous projects simultaneously under deadline pressure.
- Working knowledge of COA, Medicaid or DCFS standards (depending on role) preferred.
- Automobile and valid Illinois driver’s license required.
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Quality Improvement Specialist II
Education /Job Experience/Certification:
- Master’s Degree in human services with at least 2 years of quality improvement or program evaluation experience within social services required. OR
- Bachelor’s Degree in human services with at least 5 years of quality improvement or program evaluation experience within social services required.
Additional Responsibilities:
In addition to responsibilities of a QI Specialist I, a QI Specialist II will:
- Facilitate specialized projects, and assume increasingly independent responsibility for individual activities.
- Identify and make recommendations for areas of improvement within the Department.
- The QI Specialist II will be given additional responsibilities that may replace or supplement certain responsibilities as noted above, based on the needs of the program.
Additional Special Knowledge and Qualifications:
In addition to special knowledge and qualification requirements of a QI Specialist I, a QI Specialist II will:
- Demonstrated abilities in quality improvement, quality assurance and program evaluation activities, including problem identification and resolution, data analysis, and utilization of technology (Excel, Evolv, other).
- Demonstrated written and oral communication skills.
- Demonstrated commitment to UCAN, and its continuous quality improvement.
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Quality Improvement Specialist III
Education /Job Experience/Certification:
- A Master’s Degree in Social Work or Related Field required.
- 5 years quality improvement or program evaluation experience in social services field required, 2 of those working at UCAN.
Additional Special Knowledge and Qualifications:
In addition to special knowledge and qualification requirements of a QI Specialist I & II, a QI Specialist III will demonstrate a:
- Proven ability to independently and effectively facilitate & lead QI projects.
- Proven ability to foster positive relationships and collaborations with internal and external leaders and team members.
- Vision for the QI department, as well as for the advancement of UCAN’s mission, as a whole.