Quality Specialist

Essen Health Care is the largest privately held, multispecialty medical group in New York, providing high-quality, compassionate care to some of the state’s most vulnerable and underserved residents.

Founded in 1999, we’ve grown from a single primary care office into a network of 50+ locations offering urgent care, primary care and specialty services, from women’s health to endocrinology and psychiatry. We also provide nursing home support, care management, and in-home care through our Essen House Calls program. Guided by a Population Health model, our team of 500+ providers deliver care in-person, at home, or via telehealth, ensuring patients get the support they need when and where they need it.

We’re looking for talented, motivated individuals to join our growing team. Whether you’re a medical provider, administrator, or operations professional, there’s a career here for you. Join us in making a real difference in the health of our community.

Job Summary:

Quality specialist are responsible for monitoring, inspecting, and proposing measures to correct or improve a company's final products and processes to meet established quality standards. 

Responsibilities:

1. Review client charts using audit tools as well as internal tools to verify eligibility for each enrolled client in the program and to ensure assessments are filled out comprehensively and completely, care plans map to assessments and include SMART goals, and progress notes relate to care plans and chart client’s ongoing movement through the Health Home program.
2. Identify and provide insight into trends found in charts and documentation to provide staff with the necessary tools, trainings and guidance to ensure quality care coordination;
3. Explore areas for improvement based on collected data and work with Supervisors and the management team to identify and implement potential solutions;
4. Create & utilize spreadsheets, quality management tools and reports, and graphs to communicate data;
5. Generate and update reports using electronic health record, external, and internal databases to gather, synthesize, and convey information effectively and in a meaningful manner
6. Assist with on-going training of Care Management staff using data driven reports and analysis
7. Assist with the formulation, implementation and monitoring of corrective actions to ensure program improvement including but not limited to: policy/procedure development and review, working with established benchmarks from lead Health Homes, training, etc., tracking the implementation of corrective actions providing follow-up.
8. Conduct reviews of Incident Reports and ensure timely submission to the Lead Health Home and the Department of Health (DOH). This includes incident/accident/grievance tracking and case reviews related to incidents. 
9. Facilitate the submission of Outcome Measurement reports: Track key Outcomes and Performance measurements throughout the year, aggregating data, analyzing quarterly and annual trends and working collaboratively with program staff regarding follow-up activities and improvements.
10. Maintain up-to-date knowledge of the program regulations and any changes that occur in order to modify policies and procedures on an ongoing basis in order to ensure compliance with rules and regulations. 
11. Collaborate with the appropriate Health Home Units leadership in developing/revising policies and procedures.
12. Promote workflow redesign, structured data entry and documentation to improve care coordination, reporting and analysis.
13. Collaborate with team supervisors in the execution of PDSA cycle towards outcome improve in quality audits and reviews.
14. Coordinate follow-up on reportable incidents/complaints, including resolution of gaps in information and documentation.
15. Participate in special projects as requested by Health Home leadership. 

Qualifications:

• Master's degree in Social Work, Clinical Fields, Healthcare Fields (e.g. clinical/health/social) preferred
• Minimum 3 years supervisory experience
• Experience with quality and compliance, audits, Health Home, Medicaid and DOH regulations.
• Experience with population health and integrated care models.
• Experience with electronic health records (EHRs), Medicaid billing, ePACES, Medicaid Analytical Patient Portal (MAPP), Universal Assessment System (UAS)
• Proficient with Microsoft excel, including advanced skills with high level reports.
• Have a basic understanding of Care Management

Essen Health care is proud to be an equal opportunity employer, and we seek candidates who desire to work in and serve an ethnically diverse population.