Quality Improvement (QI) Specialist

Company: Essen Health Care
Location: New York
Posted on: March 29, 2025

Job Description:

OverviewAt Essen Health Care our tagline is "Where Care Comes Together."As the largest privately held multispecialty medical group in the Bronx, we provide high-quality, compassionate, and accessible medical care to some of the most vulnerable and under-served residents of New York State. Guided by a Population Health model of care, Essen has five integrated clinical divisions offering urgent care, primary care, and specialty services, as well as nursing home staffing and care management. Founded in 1999, our over 20-year commitment has fueled an unwavering dedication toward innovating a better healthcare delivery system. Essen has expanded from a single primary care office to an umbrella organization offering specialties from women's health to endocrinology, from psychiatry to a vast array of other specialties. All clinical services are offered via telehealth or in-person at over 35 medical offices and at home through the Essen House Calls program.Essen Health Care is the place Where Care Comes Together! We are looking for the most talented and effective individuals to join our rapidly growing company. With over 1,100 employees and 400+ Practitioners, we care for over 250,000 patients (about half the population of Wyoming) annually in New York City and beyond. From medical providers to administration & operational staff, there is a career here for you. Join our team today!Job SummaryThe QI Specialist, under the direction of the Associate Director of Quality Operations, ensures that Essen Health Home meets or exceeds quality standards. The incumbent engages in activities related to chart reviews, performance management, quality improvement, risk mitigation and management, audit preparation, and billing and compliance needs for Health Home (HH) staff working with people who have mental health, substance use, psychosocial and chronic conditions.Responsibilities

• Conduct chart reviews utilizing the internal or external Lead Health Home audit tools to verify eligibility for each enrolled client in the program and to ensure assessments are filled out comprehensively and completely, care plans align to the comprehensive assessments, include Specific, Measurable, Achievable, Realistic and Timely (SMART) goals, and progress notes relate to care plans.
• Identify and provide insight into trends found in charts and documentation to provide staff with the necessary tools, training, and guidance to ensure quality care coordination and excellence in service delivery.
• Explore areas for improvement based on collected data and work with supervisors and the management team to identify and implement potential solutions.
• Create and utilize spreadsheets, quality management tools and reports, dashboards and graphics to communicate data and performance outcomes.
• Generate and update reports using electronic health records, external and internal databases to gather, synthesize, and convey information effectively and in a meaningful manner.
• Individually consult with the CMA staff to offer training, coaching and mentoring using data driven reports and analysis, as well as feedback from Supervisors and Management.
• Assist with the formulation, implementation and monitoring of corrective action plans to ensure improvement, progress, achievement of goals and/or established benchmarks from Essen Leadership or Lead Health Homes.
• Conduct reviews and management of Incident Reports and ensure timely submission to the Lead Health Home and the NYS Department of Health (DOH).
• Facilitate and contribute to the submission of Outcome Measurement Reports, which may include tracking KPIs throughout the year, aggregating data, analyzing quarterly and annual trends, and working collaboratively with program staff regarding improvement needs and follow-up activities.
• Maintain up-to-date knowledge of the program regulations and any changes that occur to modify policies and procedures on an ongoing basis to ensure compliance with rules and regulations.
• Collaborate with the appropriate Health Home Units Leadership in developing/revising policies and procedures.
• Conceptualize workflow design and analyze structured data entry and documentation to improve care coordination, reporting, and analysis.
• Collaborate with team supervisors in the execution of PDSA cycles toward outcomes improvement in quality audits and reviews.
• Coordinate follow-up on reportable incidents/complaints, including resolution of gaps in information and documentation.
• Participate in any special projects and support other needs as requested by Essen or HH Leadership.Qualifications
  • A master's degree in social work, public administration, healthcare administration or related field preferred; bachelor's degree in similar fields required.
  • Minimum 1-2 years of experience in quality operations strongly preferred.
  • Experience with audit preparation and managing corrective action plans.
  • Familiarity with Electronic Health Records and/or Medicaid Billing (i.e., ePACES, MAPP, PSYCKES, etc.).
  • Demonstrated experience in use of common software, including Microsoft Office (i.e., Word, PowerPoint, Excel, etc.).
  • Excellent communication and interpersonal skills across all levels and backgrounds.
  • Familiarity and/or experience with working with people with mental health, substance use, chronic health conditions and/or psychosocial barriers.
  • Have a basic understanding of Care Management.
  • Strong writing and reporting skills.
  • Bilingual in Spanish preferred.Equal Opportunity EmployerEssen 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.
    #J-18808-Ljbffr

Keywords: Essen Health Care, New York , Quality Improvement (QI) Specialist, Other , New York, New York