Location: Worcester, MA - Spectrum's Corporate Administrative OfficePay Rate: $70,000 annuallySchedule: Monday-Friday The Quality Improvement Specialist – (Records and Billing) works closely with the Executive Director of Compliance and Executive Director of Quality and Systems Improvement in promoting and supporting the system-wide quality improvement plan, including collecting, analyzing and reporting performance data, and conducting clinical audits and program reviews.The position will have a special emphasis on conducting clinical record compliance reviews and ensuring service and billing codes are appropriately matched. Position scope also includes compliance reviews specific to regulatory, payor and accreditation requirements, (e.g., DPH, BSAS, DEA, MassHealth, MBPHP). Monitoring and audit/compliance reviews may occur on-site and, in some instances, remotely to the extent practicable. Attends and presents at applicable committees and improvement teams. The Quality Improvement Specialist is responsible for: Assisting program leadership in developing compliance projects, performance improvement activities and reportingConducting clinical quality record reviews, advising program leadership and staff of opportunities for improvement, including documenting findings and corrective actions neededConducting program audits to the Written Clinical Plan and newly enacted operational requirementsIdentifying and assists with training needs resulting from program/chart audits, and mock surveys - identifies resultant training needsServing as organizational single point of contact for legal and payor related record requests – ensures timely and appropriate response, documents requests via tracker spreadsheetWorking collaboratively with revenue cycle and IT staff to identify possible billing/coding errorsConducting clinical record compliance reviews ensuring service and billing codes are appropriately matched.Conducting compliance reviews specific to regulatory, payor and accreditation requirements, (e.g., DPH, BSAS, DEA, MassHealth, MBPHP)Participating in policy and procedure developmentPerforming other duties in support of the Quality Improvement Department and as assignedTraveling to Spectrum program locations to carry out responsibilitiesQualifications:Two years of compliance, licensure, accreditation, regulatory, medical records, or payor experience is requiredMaster’s degree in behavioral health, Registered Nurse, or Licensed Practical Nurse.Prior work experience with data management and statistical analysis is desirable.Must have advanced Excel skills including pivot tablesInterpersonal skills to effectively engage and interact with various levels of management, clinicians, other staff members, stakeholders and clients/families is required.Well organized, detail-oriented; and excellent time management skills with focus on meeting deadlines.Excellent verbal, social, and writing skillsMust have a valid driver’s license