Overview

The Quality Reporting and Accreditation Specialist will serve as the primary project manager for CBH's effort to obtain and maintain National Committee for Quality Assurance (NCQA) accreditation Managed Behavioral Health Organization Accreditation, Certified Review Entity Certification, and HealthChoices Reporting. The Quality Reporting and Accreditation Specialist will also assist the Director of Quality Improvement in the monitoring, documenting, and reporting of quality management activities.Essential Functions: Serves as project manager for coordinating and collaborating with accreditation and certification entities and the Office of Mental Health and Substance Abuse Services to ensure compliance with accreditation, certification, and HealthChoices requirements. Prepares CBH for accreditation, certification, and HealthChoices submissions and reviews. Develops tools that assist in determining exposure to quality risks and identifies opportunities to manage and mitigate those risks. Compiles information for quality improvement and monitoring activities, and accreditation/certification for internal use and external audits, and maintains relevant records. Works with internal departments to develop metrics to accomplish program objectives and monitors action plans relating to improving compliance with accreditation/certification requirements and quality improvement activities. Makes recommendations to CBH Officers and Quality Improvement Committee for improvements or remediation to ensure compliance to accreditation, certification, and HealthChoices requirements.Assist in assuring both internal and external program integrity by being alert to and reporting suspected instances of provider and employee fraud, waste, or abuse.Responsible for coordinating messaging of quality improvement and monitoring activities to internal and external stakeholders.Education:Education: Master's degree in behavioral health, healthcare, public administration, or social sciences. License/Certification (if applicable): Certified Professional in Healthcare Quality (CPHQ) preferred; CPHQ Required within 1 year of hire; Project Management Professional (PMP) certification is preferred. Relevant Work Experience: Minimum of 3 years post-graduate experience.Skills:Mid to high level proficiency with Microsoft Office applicationsExcellent written and verbal communication skillsKnowledge of HealthChoices regulations and requirementsKnowledge of NCQA requirementsDetail-oriented and highly organizedKnowledge of quality management, assurance, and improvement principlesAbility to work effectively with all levels of staffAbility to manage ongoing projects and prioritize appropriately to meet deadlinesCBH is a dynamic organization dedicated to providing access to high-quality, accountable care to improve the health and mental wellness of our members. CBH offers a robust compensation and benefits package, including:Family Planning, Fertility, Adoption Benefits403B Retirement PlanPTO Days/Sick DaysWellness ProgramEmployee Assistance ProgramHealth, Dental, Vision InsuranceMedical, Prescription Drug InsuranceTuition ReimbursementCommuter BenefitsFlexible Spending Core Competencies: Teamwork and Collaboration: Build and sustain relationships with co-workers and stakeholders and support efforts and deliverables. Encourage unity and help remove barriers to productivity and success. Respect: Treat each other and our members and stakeholders with respect and sensitivity, recognizing the importance of diversity. Member Centric: Focus on the needs of our members by providing value-added services, promoting strong relationships and going beyond basic expectations to achieve the best possible outcomes. Honesty and Integrity: Be open and honest in all we do. Maintain the highest level of integrity at all times. Commitment to Service Excellence: Challenge ourselves to be forward-thinking and committed to providing total member and stakeholder satisfaction, first-in-class service a