ASSISTANT CLINICAL COMPLIANCE & CQI COORDINATORBEHAVIORAL HEALTHJob Scope: The Assistant Clinical Compliance & CQI Coordinator supports agency-wide clinical compliance, continuous quality improvement, licensing, credentialing, information systems, staff education, and policy administration. This position helps maintain adherence to legal, billing, accreditation, payer, and clinical documentation standards.
The role coordinates compliance activities, monitors data and documentation, supports audits, and advances timely corrective and quality-improvement work. The position also manages assigned functions of the clinical information system (CIS), supports clinical projects, and maintains standard operating procedures and policies. Work is performed in collaboration with clinical leaders, Human Resources, Information Technology, medical records staff, and other agency departments.
Essential Functions: The work environment characteristics, responsibilities, and competencies described here are representative of those an employee encounters and is required to perform while meeting the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
I. Program ResponsibilitiesClinical Compliance and Continuous Quality Improvement
A. Support agency compliance with Joint Commission, SUPR, Division of Mental Health, Department of Children and Family Services, Department of Human Services, HIPAA, payer, safety, ethical, and other applicable requirements; assist with accreditation reviews, audits, corrective actions, and ongoing readiness.
B. Serve as a staff liaison to the Continuous Quality Improvement Committee and support meeting preparation, documentation, follow-up, and assigned initiatives.
C. Compile, validate, analyze, and distribute CQI data, outcome measures, dashboards, and quarterly and annual reports in a timely manner.
D. Complete assigned CQI tasks and procedures according to the quarterly CQI schedule, monitor due dates, and escalate barriers or overdue items.
E. Support protection of client rights and protected health information, including monitoring privacy practices and assisting with issue resolution.
F. Provide compliance guidance and technical assistance to agency staff under the direction of clinical and compliance leadership.
G. Manage licensing and credentialing activities, including applications, renewals, expirations, primary-source documentation, tracking, and timely follow-up with staff and external entities.
H. Manage assigned administration of the clinical information system (CIS), including user access coordination, data integrity, workflow support, issue tracking, testing, reporting, and liaison activities with Information Technology and vendors.
I. Develop and deliver staff education and awareness training on clinical documentation, compliance, privacy, credentialing, CIS workflows, policies, and related requirements; maintain training records and materials.
J. Coordinate clinical projects by developing work plans, tracking milestones and deliverables, facilitating communication, documenting decisions, and supporting implementation and evaluation.
K. Draft, review, organize, and maintain standard operating procedures (SOPs) for clinical compliance, CQI, credentialing, documentation, and CIS processes.
L. Review and update clinical and compliance policies in collaboration with subject-matter experts; coordinate approvals, version control, publication, staff communication, and periodic review.
II. General CompetenciesA. Promote positive image of KYC with all contacts (customers)
B. Exhibit high-quality work
C. Be a productive member of the staff
D. Demonstrate cooperation
E. Take the initiative to act on own
F. Use excellent judgment
G. Communicate clearly
H. Make use of supervision
I. Contribute to development of a culture of care
III. Core CompetenciesA. Maintain and improve compliance, credentialing, policy, training, project, and CIS tracking systems.
B. Collect, validate, analyze, and present clinical quality, compliance, utilization, and operational information.
C. Maintain complete, accurate, secure, and audit-ready records in accordance with applicable standards.
D. Coordinate cross-functional tasks, manage competing deadlines, and communicate progress, risks, and follow-up needs.
IV. Special CompetenciesA. Working knowledge of behavioral health compliance, accreditation, payer, privacy, and clinical documentation requirements.
B. Knowledge of professional licensing and credentialing processes, renewals, verification, and record maintenance.
C. Ability to learn and administer assigned CIS functions, reports, workflows, and access controls.
D. Experience maintaining accurate, confidential clinical, credentialing, training, policy, or project records.
E. Strong data-management, analytical, organizational, and deadline-tracking skills.
F. Ability to support audits, accreditation readiness, corrective actions, and continuous quality improvement activities.
G. Ability to develop clear training materials, SOPs, policies, reports, and professional communications.
V. Clinical CompetenciesA. Ability to protect client rights, confidentiality, and protected health information.
B. Ability to partner with clinical staff and leaders to improve documentation quality, workflow reliability, and service outcomes.
VI. Education and Experience- Bachelor's degree in behavioral health, health administration, social work, psychology, public health, quality management, health information management, or a related field; equivalent relevant experience may be considered.
- One or more years of relevant experience in clinical operations, compliance, quality improvement, credentialing, health information systems, project coordination, or behavioral health services preferred.
VII. Work EnvironmentA. This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines.
B. While conducting external KYC business or traveling between sites, the employee may be exposed to fumes or airborne particles as well as changing weather and road conditions.
C. Minimal travel required
VIII. Physical DemandsA. The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of the job.
B. While performing the duties of this job, the employee is regularly required to talk or hear, use eyes to see and scan the environment
C. The employee frequently is required to stand; walk; use hands to finger, handle or feel; and reach with hands and arms; bend or stoop as necessary.
D. Employee is occasionally required to carry, move, or transport computers or other objects weighing as much as 25 lbs.
IX. Chain of Authority/Responsibility- Reports to the Center of Excellence Director or designated clinical leader.
X. Schedule/Time Keeping/Time-OffA. Full-Time, Salary Up to37.5 Hours Per Week
B. Time Keeping - Accurately record hours worked in the electronic timekeeping system (on a daily basis when possible) in accordance with the timekeeping policy and practice.
Pay Range: $68,000 - $78,000 per hour
