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Quality Management Specialist Team Leader

Quality Management Specialist Team Leader

Community Behavioral Health.Philadelphia, PA, US
17 hours ago
Job type
  • Full-time
Job description

Job Description

Job Description

The Quality Management Team Leader is responsible for providing support to the Provider Monitoring and Complaint and Grievances Units in the Quality Management Department. This includes assisting in processing grievances and complaints, addressing quality of care concerns and supporting team members.

Essential Functions :

  • Completion of Provider Monitoring and Complaint and Grievance Reports
  • Complete complaint investigations and applicable letters
  • Complete provider tours
  • Attend provider meetings both virtually and at provider location
  • Facilitation of meetings or grievances or complaints
  • Complaint and / or Grievance Panel member
  • Review of quality of care concerns, follow-up with Providers and if necessary, request applicable corrective actions.
  • Review of significant incident reports
  • Provide direction and support to all Quality Management staff.

Position Requirements :

  • Education : Master’s degree, preferably in behavioral health or a related field
  • License / Certification : N / A
  • Relevant Work Experience : Minimum of 4 years of experience in a clinical setting

    • Skills :

  • Knowledge of medical necessity criteria and Pennsylvania Client Placement Criteria
  • Knowledge of Philadelphia County’s levels of care criteria
  • Knowledge of PA Act 68, Appendix H regulations
  • Understanding of diagnostic criteria and appropriate treatment approaches, clinical guidelines or best practices
  • Strong interpersonal skills
  • Understanding of DBH and DHS systems and services

    • Core Expectations :

    CBH will hold each employee accountable to the following expectations which align with our mission, vision, and corporate code of conduct.

  • Perform key responsibilities as detailed in this job description in a dependable, responsible, and positive manner
  • Serve as a role model by exemplifying professional behavior, language, skills, and attire in order to promptly and accurately service the needs of stakeholders and their families
  • Assure adherence to CBH policies and procedures so that all work is of the highest quality and delivered in the most culturally competent and cost effective manner
  • Promote and manage diversity and acceptance within CBH and with all stakeholders by honoring and respecting their individuality, dignity and rights
  • Offer suggestions and develop solutions to help promote effective and efficient work processes and innovative programs
  • Actively participate in required meetings and complete all mandatory trainings
  • Maintain high levels of advocacy and confidentiality to ensure the success of CBH and our mission

    • CBH offers a robust compensation and benefits package, including :

  • Family Planning, Fertility, Adoption Benefits
  • 403B Retirement Plan
  • PTO Days / Sick Days
  • Wellness Program
  • Employee Assistance Program
  • Health, Dental, Vision Insurance
  • Medical, Prescription Drug Insurance
  • Tuition Reimbursement
  • Commuter Benefits
  • Flexible Spending

    • Philadelphia Residency Requirement :

  • The successful candidate must be a current Philadelphia resident or become a resident within six months of hire.

    • U.S. Authorization Requirement :

  • CBH does not provide sponsorship for applicants requiring future work authorization. All candidates must be legally authorized to work in the United States without requiring sponsorship now or in the future.

    • Equal Employment Opportunity :

  • We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CBH is an equal opportunity employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on all qualified individuals. This is without regard to race, ethnicity, creed, color, religion, national origin, age, sex / gender, marital status, gender identity, sexual orientation, gender identity or expression, disability, protected veteran status, genetic information or any other characteristic protected individual genetic information, or non-disqualifying physical or mental handicap or disability in each aspect of the human resources function by applicable federal, state, or local law.

    • Requesting An Accommodation :

  • CBH is committed to providing equal employment opportunities for individuals with disabilities or religious observance, including reasonable accommodation when needed. If you are hired by CBH and require an accommodation to perform the essential functions of your role, you will be asked to participate in our accommodation process. Accommodations made to facilitate the recruiting process are not a guarantee of future or continued accommodation once hired.
  • If you would like to be considered for employment opportunities with CBH and have accommodation needs for a disability or religious observance, please send us an email at CBH.Recruitment@Phila.gov
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    Quality Team Leader • Philadelphia, PA, US