The Richmond Behavioral Health Authority is seeking a detail oriented Quality Specialist to join our SUD Division. This position will perform difficult administrative work planning, organizing, directing and providing guidance and/or developing logical processes to implement quality improvement actions that ensure the security and confidentiality to consumer medical records are in compliance with laws, regulatory, HIPAA and Authority standards; ensuring billable services were adequately documented to substantiate payment for services rendered minimizing risk of retraction; reviewing records to ensure clinical soundness and best practices are being utilized to ensure client’s needs are met; and related work as apparent or assigned. Work is performed under the general direction of the Quality Assurance Program Manager.

Essential Functions

• Reviews and monitors documentation for compliance with Authority/regulatory/reimbursement standards and clinical soundness, admission/discharge/transfer eligibility and readiness and to ensure compliance with Licensure, Department of Medical Assistance Services (DMAS) regulations and Authority standards.
• Provides training to address findings from quality reviews to enhance best practices, clinical soundness, effective interventions, regulatory compliance and person-centered components per licensure (DBHDS), DMAS and Authority standards.
• Assists with program evaluation and strategic planning processes to improve and address barriers to quality service delivery.
• Completes appropriate billing documentation for Richmond Behavioral Health Authority.
• Prepares and distributes reports including cost estimates and outlining activity including narrative and statistical summaries.
• Assists with developing/monitoring implementation of short- and long-range plans for SUD & Primary Health Care services, quality assurance services delivery and systems integration.
• Summarizes review findings for submission to supervisory staff; prepares reports or provides requested information as needed.
• Identifies problems; evaluates pertinent factors; develops/implements logical solutions.
• Develops presentations, training documents and communication related to quality services.
• Develops and maintains data systems and internal processes for monitoring overall quality of services.