About the Position
The CCF is seeking a dedicated Quality Improvement & Data Coordinator. Working under the direction of the Director of Quality and Compliance, the Quality Improvement & Data Coordinator is responsible for systematically monitoring, evaluating, and auditingservice delivery with the intent to improve quality, compliance, and appropriateness of client/consumer care through continuous quality improvement initiatives. This position also supports data-driven decision making by developing, maintaining, and analyzing reports and dashboards that monitor program performance, identify trends, and support quality improvement and regulatory compliance. The coordinator works collaboratively with internal staff and contracted providers to improve quality outcomes and ensure compliance with all program policies, procedures, and regulations.
About the Collaborative for Children and Families (CCF)
CCF is a New York state non-profit 501 (c)3 collective comprised of community-based organizations whose collective mission is to ensure that vulnerable adults, children, and their families receive individual care coordination and access to services within their homes and communities. CCF is a designated Health Home Serving Children (HHSC) and Health Home Serving Adults (HHSA) with a provider network of over 40 sub-contracted Care Management Agencies (CMAs). Our CMAs serve children, adults, and families throughout the five boroughs of New York City, the Lower Hudson valley region, Nassau, Suffolk Counties. We respond in part to external stakeholders including New York State initiatives such as Children’s Health Homes and the evolving managed care programs in medical and behavioral care for Medicaid-eligible children.
Collectively, CCF serves nearly all the youth in foster care in the greater New York City area and nearly 60% of the children and families receiving preventive care. On any given day, CCF members agencies serve more than 20,000 children and adults, providing foster care, preventive care, early childhood education, schools and educational programs, behavioral health, school-based mental health, case management, summer camps, after-school programs, and residential treatment.
Responsibilities
- Under the direct supervision of the Director of Quality and Compliance, the Quality Improvement and Data Coordinator will use the audit tool developed by CCF to review member case records in accordance with CCF’s QI and Compliance Plan as per NYS Health Home Standards and Regulations.
- Conduct member case record reviews and analyze audit findings to identify trends, opportunities for improvement, and areas requiring correction action.
- Work under the direction of the Director of Compliance and Quality Improvement to ensure CMAs are effectively monitored and remain compliant with city, state, and federal regulations.
- Develop, maintain, and update Microsoft Power BI dashboards and reports to monitor quality, compliance, operational performance, and key performance indicators.
- Perform routine data validation and investigate discrepancies to ensure the accuracy and integrity of reports and dashboards.
- Generate and analyze compliance and data reports from multiple systems (i.e., Foothold Case Management, MAPP; UAS; ePaces, etc.) to support chart audits, performance monitoring, and quality improvement initiatives.
- Prepare reports, presentations, graphs, and performance summaries as requested by the Director of Quality and Compliance.
- Prepare audit schedules and analyses required by auditors. Investigate audit findings and recommend corrective actions for identified deficiencies.
- Review and provide ongoing billing reports for fiscal oversite and monitoring.
- Act as liaison between CCF Health Information Technology (HIT) platform and CCF CMA agencies regarding claims inquiries, billing errors, data reporting, and other identified billing and operational issues.
- Undertake special projects and prepare special reports as assigned by the Director of Quality and Compliance and Executive Leadership.
- Provide back-up assistance to other staff and programs as needed.
- Attend and participate in internal meetings, committee meetings, trainings, and quality improvement initiatives.
- Comply with all measures for patient confidentiality and the security of electronic information,
Requirements
- Minimum bachelor’s degree, master’s preferred.
- Minimum 3 years’ experience in healthcare quality improvement, compliance, data analytics preferably in a health care and or mental health environment required.
- Experience managing large datasets using Excel, including pivot tables, formulas, sorting/filtering, and reporting.
- Experience using Microsoft Power BI to build, maintain, and update dashboards and reports.
- Familiarity with the extraction and manipulation of data from disparate sources.
- Comfortable working with multiple healthcare systems, databases, and reporting tools.
- Knowledge of the NYS Medicaid eligibility requirements and benefits (i.e. Health Home, Department on Health (DOH) preferred).
- Understanding of Health Home service concepts being provided in relationship to billing requirements.
- Comfortable with Billing Data Concepts (Accounts Receivable, Claims, Remittance, Denials, etc.).
- Ability to manage overview of billing workflows.
- Knowledge with government contract billing and reimbursement.
- Knowledge of Office of Medicaid Inspector General (OMIG) rules and regulations.
- Able to read EOBs and Medicaid remittances.
Additional Qualifications
- Medicaid Billing strongly preferred.
- Excellent time management and documentation skills.
- General math skills with particular attention to detail.
- Microsoft proficiency: Word, Excel, and PowerPoint.
- Able to work well with colleagues in order to identify, resolve and share information in regards to the billing flow.
- Able to handle expected volume of work/quickly resolve problems and escalate appropriate problems to management.
- Adapts well to change.
- Excellent communicator with good interpersonal skills.
- Ability and willingness to attend workshops/trainings/webinars upon request.
- Accepts responsibility for accuracy of data.
- Ability to work independently with little supervision.
- Applies common sense understanding to carry out detailed but uninvolved written or oral instructions.
It is the policy of the CCF that the company wholly complies with the equal treatment of all employees and applicants for employment, without unlawful discrimination as to race, creed, color, national origin, sex, age, disability, marital status, sexual orientation, citizenship status or veteran status in all employment decisions, including, but not limited to recruitment, hiring, compensation, training and apprenticeship, promotion, upgrading, demotion, downgrading, transfer, layoff, termination and all other terms and conditions of employment.
IV. WORKING CONDITIONS:
- Remote position
- 35 hour/week, flexible in accordance with program needs
- Some nights and weekends may be required
Pay: $55,000.00 - $60,000.00 per year
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Flexible schedule
- Flexible spending account
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
- Work from home
Application Question(s):
- Do you have a Certification in Power BI?
Experience:
- Power BI: 1 year (Preferred)
Work Location: Remote
