The Quality Improvement Director EAP supports the New Directions/E4 EAP business through development of processes to ensure optimal service delivery and set internal organizational targets as well as customer performance expectations and contractual performance standards. The Director promotes results oriented focus on Continuous Quality Improvement through development, oversight and management of an annually reviewed and potentially revised QI Program Description. The Director reports directly to the Vice President of EAP with a dotted line to VP, Quality Management and Accreditation and serves as a liaison to other departments/divisions supporting EAP service delivery including but not limited to Network, IT, Reporting, Sales, to represent EAP quality objectives and ensure quality oversight specific to EAP. The quality director will organize where needed and provide leadership of work groups including key internal stakeholders solidifying clinical and service processes, goals, outcomes, satisfaction metrics, risk management and implement quality of care improvement studies as needed using a Six Sigma Model of Define, Measure, Analyze, Improve and Control processes. Quarterly internal reports will be developed to track and trend metrics against targets. Where there are gaps in performance identified, The Quality Director will facilitate/lead workgroups, teams or committees to implement performance improvement initiatives tracking changes in processes and resulting outcomes. Process, policy or operational changes resulting from process improvement changes will be codified. EAP Performance Measures willcontinue to be evaluated against evolving EAP industry standards and customer expectations.
Directs QM program for clients served by New Directions EAP through, but not limited to, activities as described below.
• Develops and maintains compliance with policies and procedures, as well as accreditation, regulatory and customer requirements for day-to-day operations and future planning.
• All metrics related to ease of access and availability to New Direction’s call center. This will include metrics for average speed of answer, abandonment rate, telephone service factors where required, specifying these measures for access toCustomer Service first answer, clinical first answer, designated provider lines, access to designated management resources support consultation and access to Critical Incident Stress Management (CISM) consultation.
• The problem/grievance resolution/response rates and rate of satisfaction with the resolution to include problem resolution specific to member complaints and resolution of problems identified by customers/clients. Account management will be engaged in tracking and trending this metric assisting identification in opportunities for improvement.
• Satisfaction with CISM timeliness, service delivery and follow-up as measured by a satisfaction survey additional EAP (other) services including multiple metrics such as satisfaction with initial consultation, provider dispatched to supportservice delivery, impact of intervention as it supports return to productivity and supporting employees requiring
• Satisfaction with the formal referral, supervisory referral consultation and cases including rate of successful return towork for mandatory post treatment.
• Follow-up rates where follow up is an imbedded component of the service delivery. This includes: mandatory/supervisor referrals, CISM, emergent/urgent EAP calls, employees with substance abuse diagnoses, work life service requests
• Penetration rates overall to include telephonic, in-person, web-based work-life, L/F including tracking of reasons for members seeking EAP counseling/assistance and specifying substance abuse identification rates. These metrics will be reported overall by model and by customer and include average sessions by EAP model.
• ROI measure(s) that could include outcomes metrics demonstrating user improvement (self-reported or by alternative as available) in several dimensions including but not limited to: work productivity, reduced absenteeism, reduction in reported symptoms, improved emotional wellbeing , improvement in overall health including physical health, improved relationships.
• Satisfaction metrics for members, customers (with account management, EAP services, network access and other services), by New Directions as an organization and customer specific measures (with potential for a membership threshold to ensure reliable, valid measures). EAP Provider satisfaction surveys will also be developed to ascertain and improve our provider relationships. The quality manager may be required to refine and/or develop survey tools and distribution processes to gather reliable, actionable satisfaction metrics.
• Support and leadership to address customer /operational concerns around metric accuracy identified. The quality manager will collaborate with IT/reporting/operations and account management to identify and address potential analytic errors to ensure reporting precision and inclusion of actionable measures
The above will be reported quarterly to internal stakeholders with ongoing tracking and trending to ensure operational excellence and identification and implementation of quality improvement initiatives based on findings and objectives.
EDUCATION & EXPERIENCE
• 3 or more years of experience in healthcare-related Quality Management, Performance Improvement, Quality Control or Accreditation
• Licensed behavioral health clinician, or Master’s degree in health administration or business management related field
• Experience in auditing, data collection, data interpretation and analysis, statistical analyses, team processes, change initiatives and preparation of reports
• CPHQ certification; Lean Six Sigma certification or other quality-related certification; or willingness to acquire within a year of hire
• Licensed behavioral health clinician,
• Experience in EAP
• Demonstrated initiative, critical thinking, and problem-solving skills
• Strong interpersonal skills, including ability to interact professionally and positively with internal and external customers
• Ability to manage and coordinate multiple projects and staff simultaneously in a professional manner