Posting: Quality Improvement Coordinator - Development Centers

November 14, 2022

Position Title:  Quality Improvement Coordinator

Department:  Administration

Supervisor:  Quality Improvement Director

Position Expectations:

A. General Description

This is a professional position providing a wide range of support for the Quality Improvement Division. Some of these activities include standardizing manuals, forms, policies and procedures; and assisting in the efficient clinical review and evaluation of programs. The position involves having direct responsibility for improving systems in order to better support persons served.

B. Responsibilities and Duties 

  • Assists with all accreditation activities and preparation for the CARF Survey process.
  • Responsible for the facilitation of the review of Critical and Sentinel incidents; creation of a Root Cause Analysis Report.
  • Co-Facilitates the Behavior Treatment and Utilization Review committees with the Medical Director to offer clinical recommendations to staff/teams seeking support for challenging cases; as required by the fund source or to sustain mandated treatment.
  • On a daily basis, will review incident reports via an electronic system. Will be responsible for categorizing events based on level of urgency and will manage the follow up reporting process.
  • Responsible for Death Reporting Process- confirm with the Medical Examiner’s office, complete reports via MHWIN system; notify DWIHN in accordance with time requirements and follow up with staff/programs as necessary.
  • Maintain electronic policy system through review and updates; involved in the creation of new policies as necessary in maintaining compliance with regulatory bodies.
  • Standardize agency forms; archive older versions of forms and documents and upload to the Sharepoint for staff use.
  • Attend Meetings, facilitate and participate in trainings and other project management activities as required.
  • Lead external audits as one of the main contacts for the Agency, providing information and documentation as necessary and streamline the process for auditors and staff.
  • Lead internal review audit process; create schedule of internal reviews, work with program staff to conduct the review using appropriate EBP/Standardized Auditing Tool; provide clinical recommendations and follow up to ensure the recommendations are being followed and incorporated into treatment.
  • Monitoring the results of external audits; verification and facilitation of the corrective action process.
  • Act as the subject matter expert on Evidence Based Practice and other clinical care methodologies.
  • Support the Quality team as a leader, guide and support interns where needed. Provide training where appropriate on Quality Improvement initiatives.

C. Knowledge and Skills

  • Proficient in Microsoft Office Products
  • Ability to work independently, to tolerate ambiguity and changing priorities
  • Flexible and able to switch gears easily
  • Ability to complete tedious tasks repeatedly, with precision
  • Able to communicate effectively; both verbally and in writing
  • Excellent writing skills are required
  • Strong customer service skills and focus
  • Able to work within tight deadlines, while maintaining a high level of quality, accuracy and confidentiality

D. Minimum Qualifications

Education, licensure and/or certification

Bachelor’s Degree in Social Work or Psychology or a human service field from an accredited university; preferably with a clinical background and/or experience working in the Mental Health field.

E. Development Centers’ Position on Equity

We believe in the fair and just distribution of resources and opportunities needed to achieve wellbeing. We engage with compassion to confront and dismantle oppression interpersonally, institutionally, and systemically. We commit to building a culture of equity and belonging.


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