CENTRAL FLORIDA BEHAVIORAL HEALTH NETWORK INC
Location
Tampa, Florida
Salary
$53,000 - $59,000 / YEAR
The Quality Specialist II coordinates quality improvement, contract compliance, and service validation initiatives by monitoring Network Service Providers for adherence to contractual requirements, accreditation standards, and state statutes. This role involves serving as a primary contact for assigned organizations, conducting reviews, summarizing findings in reports, and providing necessary technical assistance to ensure compliance.
Candidates must possess a Master’s degree in a behavioral health field along with two years of experience in quality oversight for behavioral health services, or an equivalent combination of education and experience. Required competencies include knowledge of Microsoft Office, the ability to travel, and an in-depth understanding of quality assurance principles and federal/state behavioral health regulations.
Essential Job Functions Participates in the process of monitoring Network Service Providers (NSPs) to assess contract/financial compliance, validate service documentation and billing, and best practice. Ensures compliance with contractual requirements, CARF accreditation standards, HIPAA laws, and Florida state statutes that govern behavioral health services and CFBHN operations. Serves as primary point of contact for an assigned caseload of subcontracted organizations. Responds to questions and maintains contact with NSPs throughout the CQI monitoring process. Completes monitoring reports to summarize results and findings. Conducts Action Plan follow-ups as required and within required timeframes. Reviews and interprets data, as necessary, to assist in identifying trends and issues in need of NSP attention. Provides training and technical assistance to subcontracted providers, as required, to bring them into compliance with CQI requirements. Communicates monitoring results to other CFBHN departments. Ensure that information in CFBHN data systems is accurate and edited or backed out as necessary. Represents the CQI department on the Critical Incident Review Committee. Conducts case file reviews assigned by CQI Manager. Writes reports to identify observations and/or other issues in need of NSP attention or correction. Maintains knowledge of Substance Abuse, Mental Health, and Block Grant programs coordinated by CFBHN. Participates in CQI Department meetings, to include CQI Oversight, Board and Network CQI Committees. Working with the CQI team, develops, updates and revises tools utilized as part of the monitoring process. Leads and/or participate in additional projects as assigned. QualificationsQualifications: Required Education/Experience Master’s degree in behavioral health field with two years of experience in providing quality oversight for the provision of behavioral health services, or an equivalent combination of education and experience. Knowledge of Microsoft Office suits the position Ability to travel as required by the position Above-average knowledge of the principles and practices of collaborative quality improvement/quality assurance In-depth understanding of system of care principles and values Knowledge of federal and state regulations related to the provision of behavioral health services Ability to manage multiple tasks and prioritize meeting deadlines Knowledge of Microsoft Office suits the position Ability to travel as required by the position We offer: Health & dental (100% paid for employee) Vision benefits (deeply discounted pricing) Hybrid role - Predominately work from home Life Insurance ($10,000 policy, 100% paid) 401k (after 90 days) Profit sharing (after six months) AD&D policy (100% employer paid) Telehealth at no cost AFLAC available 12 paid vacation days, 12 paid sick days Two paid personal days and one paid volunteer day Nine paid holidays Employee assistance program And more great benefits! Send your resume now!
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