The Quality Manager serves as a key member of the Thresholds Quality Compliance team, responsible for ensuring high standards of clinical mental health documentation and service delivery across programs. This role conducts comprehensive reviews of medical records, evaluates the quality and effectiveness of care plans, and performs utilization reviews to promote consistency and deliver hands on training for best practices. ESSENTIAL DUTIES & RESPONSIBILITIES Responsible for inâdepth review and evaluation of operational systems, documentation, and service delivery according to the expectations and regulations of the various funding sources and with the highest professional standards. This may include but is not limited to the standards and documentation requirements as established by: CARF, Medicare, Medicaid, DMH, CILA, DOL, DORS and/ or DCFS. Identifies areas where Medicare/Medicaid billing could be maximized. This may include proofreading written client information identifying clients’ mental health needs and treatment recommendations. Such direction shall, at minimum, require a faceâtoâface meeting with client. Identifies areas for improvement, and, in collaboration with the Program Director, puts corrective actions in place. Makes recommendations as to additional training needed for staff. May provide direct hands-on training. Responsible for helping Programs create and enhance a therapeutic environment. Attends and participates in task force meetings and other agencyâwide committees as assigned. Provides clinical direction as to the development and review of members’ Individual Treatment Plans (ITP). This requires face to face meetings with client or guardian to identify goals, objectives, specific mental health services needed, and identification of staff responsible for delivering the services. May need to approve and sign the final ITP. Advises direct service staff regarding appropriate responses to members’ needs. Develops criteria by which to review the delivery of all departmental services and make recommendations to assure they operate using the values and principles of recovery. Ensures that this department functions optimally, in conjunction with other branches or departments of Thresholds. Assures that all Thresholds records are organized in a systematic and organized fashion. Follows all appropriate safeguards with regard to the confidential files maintained at the Program. Follows all policies and procedures pertaining to all records including but not limited to restricting access to all records per agency policy. Provides accurate and timely information to superiors on all topics and issues related to the operation of the agency and the well-being of its staff and members. Other duties as assigned.
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Job Type
Full-time
Career Level
Manager
Number of Employees
1,001-5,000 employees