Quality Improvement & Compliance Specialist

• Location 1323 E 71ST ST,Tulsa, OK, ,United States
• Job Category 0, 0
• Employee Type Full Time
• Required Degree Masters
• Manage Others No

1. Strong understanding of Quality Assurance and Quality Improvement processes in healthcare, clinical documentation standards, and evidence-based practices.

2. Ability to conduct clinical record reviews and support performance improvement initiatives.

3. Excellent communication, coaching, and facilitation skills, with experience delivering clinical documentation and compliance training.

4. Proficiency in data tracking and report tools (e.g., Excel, EHR systems).

6. Ability to work independently with moderate latitude for the use of initiative and independent judgment in fulfilling job responsibilities, and to collaborate effectively within a team environment.

7. Ability to adapt to working in a fast-paced environment.

8. Practices and promotes the Sanctuary Model’s Seven Commitments: nonviolence, emotional intelligence, social learning, open communication, social responsibility, democracy, and growth and change.

9. Uphold CRS Code of Ethics by conducting professional activities with honesty, integrity,respect,fairness,andgoodfaithinamannerthatreflectspositivelyuponthe organization.

• Assist in the implementation and monitoring of QAQI initiatives to ensure services meet best-practice standards and regulatory requirements.
• Conduct qualitative reviews of behavioral health clinical records, including annual documentation audits for all behavioral health clinical staff, as assigned by the QAQI Director, to evaluate the clinical appropriateness, individualization, and quality of documentation in accordance with ODMHSAS, OHCA, and CARF standards.
• Serve as clinical lead for the agency’s quarterly peer reviews in accordance with CARF standards, including maintaining the review tools, training clinician reviewers, and translating findings into coaching and training recommendations.
• Conduct service-to-documentation reviews of billed behavioral health services to evaluate whether clinical documentation supports medical necessity for the services provided (e.g., behavioral health diagnosis, assessed need, and service plan justify the type and amount of service), in accordance with OHCA, ODMHSAS, and CCBHC requirements.
• Conduct follow-up assessments to evaluate whether corrective action plans and documentation training have effectively improved the clinical quality of documentation.
• Maintain records of coaching and corrective actions and report them to the QAQI Director; submit qualitative review results to the QA Business Intelligence Specialist for aggregation and trend reporting.
• Assist with critical incident review and compliance with regulatory reporting requirements and agency procedure adherence.
• Serve as a resource to staff regarding audit processes, findings, and expectations.
• Support accreditation survey readiness and state licensure/renewal preparation activities, including evidence collection, documentation review, and staff preparation, as directed by the QAQI Director.

• Provide individualized coaching to clinicians and support staff on clinical documentation, related workflows, and documentation of evidence-based practices, based on audit and review findings.
• Serve as the clinical documentation and compliance content expert for training developed and scheduled by the Training Specialist, including co-facilitating sessions on documentation and compliance topics.
• Assist with clinical documentation training for newly hired clinical staff as part of onboarding coordinated by the Training Specialist, in alignment with CCBHC protocols.
• Identify…