Health and Wellness Quality Assurance/Quality Improvement Coordinator
Contract
$60k - $65k/yr
Mid
Bachelor's
Staten Island, NY, USA
In PersonTravel between Staten Island and Brooklyn may be necessary.
Risk & ComplianceInternal Audit & Controls
About the job
Requirements
Strong analytical skills.
Computer fluency in Outlook, Excel, Access, SQL, Word, and PowerPoint.
Knowledge of navigating electronic health records.
Extensive understanding of Medicaid (OMIG) regulations, Department of Health compliance, and HIPAA.
A bachelor's degree in social work, social services, healthcare, or a related field is required.
At least three years of experience in a similar quality assurance/quality improvement role is required.
Knowledge of continuous quality improvement methodology, including PDSA, the CQI Cycle of Learning and Improvement, and Lean Six Sigma.
Work hours may vary based on program needs.
Ability to travel between Staten Island and Brooklyn may be necessary.
Responsibilities
Monitor performance for Article 29-I, CFTSS, Health Home Care Management, and Bright Beginnings in collaboration with program leadership.
Demonstrate understanding of Article 29-I, CFTSS, and Health Home Care Management contract expectations and service-delivery standards to support coordination and quality of services.
Propose methodologies and, upon approval, conduct monthly internal audits of Article 29-I, CFTSS, and Bright Beginnings to assess practice quality, billing compliance, and contractual adherence.
Complete and submit quarterly HHCM CCF chart audits and conduct quarterly eligibility audits.
Recommend resolutions to potential infractions and practice or protocol gaps using a continuous quality improvement approach; assist in creating action plans, oversee implementation, assess impact, and ensure timely required reporting and follow-up.
Monitor corrective action and improvement plans through resolution.
Develop and monitor key performance indicators through visual reporting platforms to track trends, highlight strengths, identify improvement opportunities, and support data-driven decisions.
Coordinate internal and external audits, site visits, program reviews, and evaluations conducted by regulatory bodies; provide statistical analysis and trend reporting on audit results.
Assist with developing, modifying, and implementing agency policies and procedures consistent with current City, State, and Federal regulations.
Provide technical assistance and capacity building, and educate agency staff about quality assurance and continuous quality improvement processes.
Work across Foster Care, Prevention, Safe Passage Domestic Violence, and Childcare to support continuity of care.
Collaborate with quality assurance/quality improvement team members to support departmental work and operational excellence.
Attend internal and external stakeholder meetings, staff meetings, and training courses.
Perform other duties and responsibilities as assigned within the scope of the position.
Desired Qualifications
Prior experience in a child welfare nonprofit is a plus.
Description
This is aTEMPORARY POSITION
The Organization:
Founded in 1846 to care for the children and widows of sailors in the Port of New York, Seamen’s Society was one of the first organizations, in the US, to care for abandoned children in family settings, rather than institutions. Today, Seamen’s Society for Children and Families (SSCF) is a comprehensive nonprofit provider of enhanced family foster care services, mental and behavioral health care services, health home care management, prevention/family stabilization services, domestic violence intervention and counseling services, and a childcare program. The agency’s approximately 200 professionals serve over 1,200 children and 800 families in New York City.
Job Summary:
Under the direct supervision of the Quality Assurance/Quality Improvement Manager, the Health and Wellness QA/QI Coordinator is responsible for monitoring program performance for Article 29-I, CFTSS, Health Home Care Management (HHCM), and Bright Beginnings in collaboration with Program Leadership to support continuous quality improvement initiatives. The Health and Wellness QA/QI Coordinator is tasked with data collection and analysis, conducting audits and reviews, developing performance reports, monitoring Key Performance Indicators (KPIs), creating improvement tools, and ensuring compliance with agency procedures, regulatory policies, and HIPAA regulations. The Health and Wellness QA/QI Coordinator will partner with Program Leadership and Staff to assist in the establishment of monitoring strategies to improve departmental efficiency with a shared goal of creating meaningful differences for the children, youth, and families served.
Primary Duties and Responsibilities:
· Demonstrate a strong understanding of Article 29-I, CFTSS, and Health Home Care Management contract expectations and standards for service delivery to promote the coordination and collaboration of the highest quality services delivered to children, youth, and families entrusted to our care.
· Propose methodologies and, upon approval, conduct monthly internal audits of Article 29-I, CFTSS, and Bright Beginnings to assess quality of practice, billing compliance, and adherence to contractual regulations. Complete and submit the quarterly HHCM CCF chart audit and conduct quarterly eligibility audits.
· Using a Continuous Quality Improvement approach, provide recommendations to Program Leadership to resolve potential infractions and/or identified gaps in practice and/or protocols. Assist in the creation of action plans, provide oversight for implementation, and assess impact. In accordance with regulatory standards, ensure reporting and required follow-up are completed in a timely manner. Monitor corrective action/improvement plans through resolution.
· Develop and monitor Key Performance Indicators (KPIs) through visual reporting platforms that track performance trends, highlight program strengths, identify opportunities for improvement, and support data-driven decision making.
· Support the coordination of internal and external audits, site visits, program reviews and evaluations conducted by City, State, Federal and all other regulatory bodies. Provides statistical analysis and trend reporting on the results of all audits.
· Assist in the development, modification, and implementation of SSCF policies and procedures that are consistent with current City/State/Federal regulations.
· Provide technical assistance and capacity building. Educate agency staff on the importance of the quality assurance and continuous quality improvement processes.
· Work cross departmentally with Foster Care, Prevention, Safe Passage Domestic Violence, Childcare to ensure continuum of care for the children and families served.
· Collaborate with other QA/QI Team Members to collectively support departmental work and further promote operational excellence.
· Attend internal and external stakeholder meetings, various staff meetings, and training courses.
· Performs other duties/responsibilities as assigned within scope of position.
Requirements
Skills, Knowledge, and Abilities:
· Strong analytical skills
· Detail-oriented and organized
· Excellent interpersonal/communication skills
· Computer literate including demonstrated fluency in Outlook, Excel, Access, SQL, Word, PowerPoint
· Demonstrative knowledge navigating Electronic Health Records
· Extensive Understanding of Medicaid (OMIG) Regulations, DOH Compliance, HIPAA
Qualifications/Requirements:
Bachelor’s degree in social work, social services, healthcare, or related field required
Minimum of 3 years working in a similar QA/QI role
Prior experience in a child welfare nonprofit a plus
Knowledge of Continuous Quality Improvement Methodology including but not limited to PDSA, the CQI Cycle of Learning and Improvement, Lean Six Sigma
Due to the nature of the work environment work hours will be based on needs of program and may vary.
Seamen’s Society operates in 2 locations: Staten Island and Brooklyn. The ability to travel between sites may be necessary.
Additional Information: Seamen’s Society is committed to providing an inclusive and welcoming environment for all members of our staff, participants, volunteers, subcontractors, and vendors. We respect diversity and accordingly are an equal opportunity employer that does not discriminate on the basis of race, color, creed, religion, national origin, alienage, citizenship status, age, disability, sex, gender, gender identity or expression (sexual orientation, marital status, partnership status, veteran status, genetic information, or any other status protected by applicable federal, state, or local law.