Overview

Are you interested in improving the quality of life for the people in your community? Do you have a passion for ensuring that those with mental health and substance use disorders receive the services they need? Are you looking for a place to work that is committed to the development of staff and matching people to work they love? A place that values a diverse workforce that strives for excellence while maintaining a healthy work/life balance? Then come join us!Quality Assurance SpecialistSouthwest Michigan Behavioral Health • Quality & Clinical Outcomes • Office/Home Reports To Director of Quality FLSA Status Exempt Compensation Commensurate with experience THE QUALITY ASSURANCE SPECIALIST OPPORTUNITYAs our Quality Assurance Specialist, you'll monitor and improve the quality of behavioral health services across the region - leading audits, tracking performance data, and driving improvement projects that make a real difference for the people we serve.WHAT THE QUALITY ASSURANCE SPECIALIST WILL OWNExternal audits (HSAG, MDHHS, CMHSP site reviews) and provider action plansQAPIP development, KPIs, and performance improvement projectsCritical incident and sentinel event review, root cause analysis, and trend reportingThe SWMBH survey process and member experience analysisSubject matter expertise and coaching on quality improvementWHAT THE QUALITY ASSURANCE SPECIALIST NEEDS TO BRINGBachelor's in social work, psychology, healthcare administration, statistics, or a related human services fieldExperience in quality assurance, auditing, and/or project management, with a track record leading improvement projectsStrong data analysis and reporting skills; advanced Microsoft Office 365 Keep scrolling for the full position details, or jump straight to applying below. QUALITY ASSURANCE SPECIALIST - FULL POSITION DETAILSThe Quality Assurance Specialist monitors, collects, reviews, and reports data to meet contractual requirements and support continuous improvement projects. The Quality Assurance Specialist monitors internal SWMBH measures and data elements, organizes projects, coordinates external audits, and provides subject matter expertise in business process analysis and performance improvement.QUALITY ASSURANCE SPECIALIST DUTIES & ESSENTIAL FUNCTIONSIdentify quality initiatives that improve regional clinical performance, member outcomes, and access to services, in line with federal, state, contractual, and accreditation requirementsHelp develop the annual Quality Assurance and Performance Improvement Program (QAPIP) Plan and Evaluation; support regional implementation, including KPIs, Performance Improvement Projects, strategic imperatives, and QAPIP goal tracking across departmentsReview critical incidents to determine sentinel event status, support timely root cause analysis, assist with mortality reviews, and analyze quarterly trends for Critical Incident Reporting System submissionsLead and coordinate external audits (HSAG, MDHHS, CMHSP site reviews): consult throughout, prepare reports, and manage remediationDevelop action plans with partners to address performance issues and monitor progressManage the SWMBH survey process, from distribution and collection to communicating outcomesAnalyze member experience assessments to identify trends in quality, availability, and accessibility of care; recommend, track, and evaluate systemic action stepsTrack and analyze project details; maintain internal systems for projects, audits, and reportsReport information to external stakeholders per federal, state, and contractual requirementsServe as subject matter expert on quality assurance and performance improvement; coach internal and external customers on improvement methodsManage multiple audits and initiatives at once, with strong organization and attention to detailIf staffed by someone with an active clinical license, may join clinical chart reviews and audits of SWMBH providers and CMHSPsQUALITY ASSURANCE SPECIALIST QUALIFICATIONSRequiredB