Job Details

Overview

Quality Assurance Compliance Specialist - PSS role at Multnomah County. This is an internal job posting. Current employees: please apply through the employee portal to be considered. Pay range: $42.71 - $52.58 hourly. Department: Health Department. Job Type: Regular Represented. Exemption Status: United States of America (Non-Exempt).

The opportunity is in the Quality Management (QM) and Compliance Program of the Behavioral Health Division (BHD). It focuses on quality assurance and quality improvement processes, measurement of performance and quality indicators, and monitoring of compliance standards for contracted providers and county behavioral health services. The position works with programs in BHD that provide billable clinical services, including programs under the OAR 309-019 rule set.

Responsibilities

• Provide subject matter expertise on compliance and regulatory requirements for BHD programs that provide clinical outpatient mental health and addiction services.
• Serve as the clinical consultant for the Quality Management Compliance team on matters requiring a QMHP or licensed staff perspective (e.g., critical incidents, grievances, OAR interpretation, policies and procedures).
• Provide technical assistance to drive initiatives, support programs in improving outcomes or services, and implement requirements.
• Conduct workflow analyses to identify areas for improvement, simplify redundant processes, and address quality assurance and compliance requirements.
• Identify problems and formulate solutions independently or with stakeholders, including Oregon Health Authority (OHA) and teams.
• Collect and analyze information on policy implementation and assess the impact on service delivery and operations.
• Monitor program compliance with applicable OARs regarding provision of services, standards of care, and client health and safety.
• Provide technical assistance as needed; track Rule Advisory Committee meetings and engage with rule changes, including in-person meetings, written feedback, and communication on workload impact.
• Conduct independent research on rules, regulations, requirements, best practices, and evidence-based practices.
• Work with the BHD Billing team to review and resolve potential claims issues related to fraud, waste, and abuse.
• Maintain a general understanding of billing and claims rules.

Qualifications

Required Minimum Qualifications

• Education/Certification: Masters degree and eligibility as a Qualified Mental Health Professional - R (QMHP-R) with MHACBO. Visit MHACBO website to verify eligibility.
• Experience: Five (5) years of progressively responsible experience in program development, policy analysis, or program compliance/monitoring and evaluation.
• Knowledge, Skills, Abilities: Working knowledge of contract compliance criteria, quality indicators; experience in audits/investigations with data collection, analysis, corrective action, and compliance monitoring; experience with Medicaid billing, managed care systems, or health plans.

Other

• Background investigation may be required (fingerprinting).
• Completion of Healthcare Basic Compliance Academy within first year.

Preferred Qualifications/Transferable Skills

Note: These are not required but may be considered in identifying the most qualified candidates. Examples include:

• Certified in Healthcare Compliance (CHC)
• Ability to lead with race through actions and advocacy with internal programs, community partners, and across departments.
• Demonstrated cultural responsiveness and collaboration across diverse populations.
• Experience in healthcare compliance and in the behavioral health field.
• Transferable skills: describe relevant transferable skills in your application.

Screening & Evaluation

Application packet must include all requested items. Attach a resume, a cover letter addressing how you meet the qualifications and current certifications, and a copy of Oregon QMHP-R certification.

Selection Process

• Initial review of minimum qualifications
• Evaluation of application materials to identify the most qualified candidates
• Consideration of top candidates and interviews
• Background, reference, and education checks

Additional Information

• Type of Position: Overtime eligible; Represented; FLSA: Non-exempt
• Pay and offers: Pay range is general guidance; actual offers determined per Oregon Equal Pay Law.
• Workplace commitments: Diversity and Inclusion, Equal Opportunity Employer, Veterans' Preference; accommodation under the Americans with Disabilities Act available.

Contact information: Recruiter Caitrin Thomaselli, ...@multco.us, +1 (971) ###-####.

Job Profile: 6088 - Program Specialist Senior