**Multiple PA locations**
New Directions Mental Health, a subsidiary of Transformations Care Network, is seeking a dedicated and experienced Quality Manager to join our team. As a leading brand in the mental health industry, we are committed to providing exceptional care and support to our patients. If you have a passion for ensuring compliance and quality in healthcare, we invite you to apply for this position.
Responsibilities:
- Collaborate closely with operations and clinical leadership to develop and maintain a data-driven compliance program, ensuring adherence to state licensing regulations, Medicaid requirements, Fraud Waste and Abuse regulations, and other regulatory/payor source requirements.
- Establish processes and protocols to identify gaps and areas requiring attention, providing recommendations to senior leadership.
- Create a system for ongoing monitoring and reporting of compliance and quality metrics.
- Conduct regular compliance audits to identify risks and prioritize corrective actions.
- Develop and implement staff education programs on regulatory and quality requirements.
- Stay up to date with regulations related to OMHSAS licensed clinics and state Medicaid requirements, recommending updates to policies, procedures, and workflows accordingly.
- Communicate audit information to Clinic Director and other organizational leadership.
- Assist in the development and implementation of corrective action plans.
- Coordinate responses to patient complaints from internal departments and oversight bodies.
- Ensure reporting requirements to OMHSAS and Medicaid MCOs (Managed Care Organizations) are met, including critical incident reporting.
Qualifications:
- Bachelor's degree in a mental health-related field or Healthcare Administration.
- 3+ years of experience in Healthcare Compliance, Management, or Operations.
- Thorough knowledge of Pennsylvania psychiatric outpatient regulations, behavioral health Medicaid requirements, and best practices.
- Comprehensive knowledge of the financial practices within the healthcare industry, including a deep understanding of Fraud, Waste, and Abuse.
- Demonstrate strong collaborative skills and a receptive attitude towards suggestions from team members.
- Superior attention to detail to identify and correct non-compliant practices.
- Proficiency in Microsoft Office Word and Excel.
Join our dedicated team at New Directions Mental Health and contribute to our mission of delivering high-quality mental health services. Apply today to make a positive impact in the lives of our patients and their families.