Quality Assurance Specialist

Position Overview

As a Quality Improvement (QI) Specialist under the supervision of the Chief Executive Officer, you will be instrumental in driving facility and company-wide quality improvement initiatives. Your work will directly influence the delivery of exceptional care, adherence to regulatory requirements, and the establishment of a culture of continuous performance improvement in substance use disorder treatment and general healthcare.

• Partner with all departments as a senior leader to elevate the quality of care, ensuring compliance with all regulatory and contractual requirements while fostering a culture of ongoing improvement.
• Collaborate with multidisciplinary teams to collect, analyze, and monitor quality metrics, identifying opportunities for improvement and driving data-informed decisions.
• Develop and lead the implementation of performance improvement strategies using proven methodologies to enhance efficiency, quality, safety, and patient outcomes.
• Track, evaluate, and report the status of quality initiatives, ensuring transparency and accountability across teams.
• Maintain and lead compliance with TJC/CARF standards, as well as local, state, and federal regulations.
• Facilitate survey readiness and preparedness initiatives.
• Update regulatory matrices and compliance documentation in collaboration with relevant teams.
• Analyze incident report trends to identify systemic issues and develop actionable plans to address root causes and mitigate future risks.
• Own and drive the achievement of Facility Balanced Scorecard metrics, ensuring alignment with organizational goals and sustained performance improvements.
• Oversee and optimize the quality of patient safety, privacy, and risk management processes, including ACTs investigations.
• Monitor risk areas, report findings, and implement strategies for mitigation, including staff education and sustainability monitoring.
• Provide leadership for key committee meetings, including QAPI, Medical Records, Safety, and Infection Control.
• Educate and train staff on quality improvement, patient safety, and regulatory standards.
• Analyze patient satisfaction survey feedback, grievances, and ACTS data to develop and monitor strategies that improve patient experience and outcomes.

• Strong understanding of compliance and quality standards specific to substance use disorder treatment and healthcare.
• Familiarity with healthcare regulatory requirements (local, state, federal) and accreditation standards.
• Proficiency in data collection, analysis, and reporting, including familiarity with IT systems and tools such as Microsoft Office Suite and quality management platforms.
• Experience with project management methodologies (e.g., Agile, Six Sigma) is a plus.
• Strong organizational, communication, and problem-solving skills with attention to detail.
• Analytical mindset with the ability to interpret data and translate it into actionable insights.
• Basic proficiency with IT systems used in healthcare quality management.
• Ability to manage tasks effectively and meet deadlines.
• Good organizational and communication capabilities.
• Commitment to continuous learning within the healthcare compliance field.
• Proficiency in Microsoft Office Suite and willingness to learn new software as needed.
• Ethical judgment and integrity when handling sensitive patient data, with a commitment to confidentiality in line with HIPAA and related regulations.
• Leadership skills with a proactive approach to solving problems and driving team collaboration.
• Cultural competence and sensitivity towards diverse populations.
• Eagerness to learn and thrive in a fast-paced, team-oriented environment.
• Minimum:
  Bachelor's degree in a related field preferred.
• Certification in healthcare quality and/or process improvement (e.g., Six Sigma Green Belt) is preferred.
• 1–3 years in quality improvement, regulatory compliance, or healthcare operations, preferably in substance use disorder treatment or a similar setting.
• Experience with performance improvement initiatives, compliance monitoring, and data reporting is highly beneficial.

• Enhanced Patient Care Quality and Outcomes:
  Demonstrating measurable improvements in patient care, safety, and satisfaction.
• Compliance Audit Readiness and Results:
  Maintaining a high standard of regulatory and accreditation compliance, ensuring readiness for audits, and achieving favorable results.
• Effective Data Reporting and Analysis:
  Providing accurate, timely, and actionable insights through data collection, analysis, and reporting that drive decision-making and improvements.
• Collaboration and Leadership in Quality Initiatives:
  Fostering teamwork and spearheading initiatives that promote continuous quality improvement across the organization.
• Achievement of Facility Balanced Scorecard Metrics:
  Driving progress on key performance indicators, aligning initiatives with organizational goals, and ensuring sustained improvements in scorecard metrics.

This job operates in a…