Under the direction of the Director of Quality Management, the Quality Management Specialist (QMS) will assist with administering the quality assurance duties and tasks related to ensuring continued agency compliance with all applicable state and federal rules and regulations. The QMS will conduct random and scheduled on-site and/or desk reviews to assess the quality and appropriateness of ongoing service provision. The QMS will be expected to produce varied professional communications to communicate findings, recommendations, trends and respond to queries. The QMS will assist with the agency local planning process which may include working with the Public Network and Advisory Committee to complete the local needs assessment process. Participation in MH Director’s Staff meetings. Utilization Management Review Meetings, and other Departmental meetings. Provides training as needed. Frequent day travel and infrequent overnight travel will be required as needed to meet agency business needs. Work hours may occasionally be extended to meet agency needs. Complete quality assurance processes for multiple programs and presents findings for team reviews. Develops presentations for management training, in-services and ongoing compliance initiatives.

Education, Training, and Experience (including licensure and certification)

Bachelor’s degree with a major that qualifies for a QMHP or QMRP designation.
Paid work experience that included the use of Microsoft Office.
Valid Texas driver’s license with clearance to drive agency vehicles.
Two years successful experience in the provision of services to people who receive services for mental/behavioral health or Intellectual & Developmental Disabilities (IDD)

Knowledge, Skills, and Abilities

Knowledge of local, state and federal regulations applicable to Mental Health and IDD programs
Ability to plan, assign and may supervise the work of others
Ability to interpret program requirements and procedures; and to provide guidance to other staff
Excellent verbal and written communication skill
Ability to manage working on multiple projects concurrently, to include responses to Managed Care Organizations, Utilization Management Guidelines and Billing Guidelines
Ability to work independently, perform duties with tact, diplomacy and commitment to ensuring consumers receive quality services
Ability to problem solve in a creative, viable and realistic manner
Ability to gather data, summarize and analyze findings; and communicate them in concise written reports
Knowledge of billing requirements for Medicaid, Medicare, and Medicaid waiver programs
Knowledge of Substance Use Disorders, Mental Health Crisis and IDD programs

Applicants who possess one or more of the following qualifications in addition to the minimum qualifications are preferred:

Demonstrate ability to read, write, speak Spanish
Two years of experience working in the community center system
Master’s Degree in Human Service/Human Development related field

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Quality Management Specialist II

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