Denton County MHMR Center employees are to be committed to fostering an open, inclusive, and supportive environment that welcomes and embraces diversity in all forms. Denton County MHMR Center defines diversity broadly to include race, ethnicity, abilities (mental/physical), gender, gender identity, immigrant status, language, religion, sexual orientation, socioeconomic status, veteran status, age, and other groups.
Denton County MHMR Center employees are to strive to maintain a trauma sensitive workplace, to embrace trauma sensitive and informed practices, and to foster a supportive and welcoming environment of care.
Under direction of the Program Manager of Quality Management and within federal, state and local guidelines performs routine inspection work. Work involves conducting inspections and quality assurance reviews to ensure compliance with laws, regulations, and agency policies.
The Crisis Auditor is responsible for monitoring and conducting activities under the supervision of the Program Manager of Quality Management. The position is responsible for the implementation of an on-going quality assurance program designed to objectively and systematically monitor and evaluate the quality and appropriateness of crisis services, pursue opportunities to improve consumer care and resolve problems. This position will be directly responsible for carrying out quality improvement processes and strategies focusing on crisis services and producing reports associated with quality assurance monitoring. Works under moderate supervision, with limited latitude for the use of initiative and independent judgment.
Education, Training, and Experience
· A bachelor's degree from an accredited college or university is required with a major in social, behavioral, health or human services preferred.
· Three years quality assurance experience in the HHSC service system preferred.
· One year of crisis services delivery preferred.
· Working knowledge and ability with Windows based Microsoft Office Word, Excel, Access software, E-mail and internet use or knowledge required.
Registration, Certification, Licensure, and Other Qualifications
· Must have and maintain a background and criminal history free from any disqualifying offenses as outlined by the Texas Administrative Code (TAC) and the Health and Human Services Commission (HHSC).
Department: Quality Management Program PAL: 10-135
Reports to: Quality Management Program Manager Grant Funded: ? Yes ? No
FTE Status: Full-Time Work Model: In-Person
Schedule: Monday-Friday 8am-5pm ? Exempt ? Non-Exempt
· Must possess and maintain a valid driver's license and automobile insurance.
o Individuals with an out-of-state driver's license must be able to obtain a driver's license in the state of Texas within thirty (30) days.
· Successful completion of all position-specific training within thirty (30) days of employment is required.
Knowledge, Skills, and Abilities
· Knowledge of Texas Laws, codes, and standards related to the area of responsibility; of the principles and methods of field inspection and quality control and of business practices.
· Skills in conducting inspections, in determining proper courses of action, in using instruments and tools necessary to conduct inspections; in using computer based programs and databases, and in maintaining records and written reports.
· Ability to prepare reports, to interpret laws and regulations, to gather and analyze data, and to communicate effectively verbally and in written form
· Ability to display regular and reliable (in-person, if required) attendance.
· Understanding and practice of Trauma Informed Care principles.
Essential Duties
The following list outlines key responsibilities for the position; however, it is not exhaustive and does not encompass all responsibilities. Additional duties may be assigned as needed.
1. Monitors and analyzes utilization management/resiliency, disease management, and crisis services data.
2. Develops quality indicators for review of each crisis services program service area; conducts reviews on an ongoing basis to assure assessment of current, applicable crisis services quality indicators.
3. Ensures that all crisis program/service areas to include, but not limited to the access line, crisis intervention team, MCOT and continuity of care each receive at least an annual program review.
· Develops an annual review schedule.
· Conducts reviews according to schedule.
· Provides two-week written notification to programs prior to review.
· Produces written program summary within 10 working days of review and submit to supervisor.
4. Reviews crisis services incident, medication error and safety reports.
5. Facilitates crisis services data collection and trending reports.
6. Attends the Centers Safety committee; ensures adherence to the Center's ADA related activities.
7. Completes crisis services medical record reviews as required for center self-assessment
activities; compiles deficiency reports and forward to service provider about non-compliant findings; enters results into a historical worksheet to track trends, making reports available as needed.
8. Performs trend analysis on ongoing crisis services quality review findings and submits trend reports to supervisor as required; completes assigned crisis services quality of care investigations; completes assigned crisis services focused reviews; completes Center's Death Reviews as assigned.
9. Attends utilization management committee meetings as scheduled.
10. Conducts utilization reviews or care reviews as assigned to determine appropriateness of eligibility determinations; use of exceptions and overrides to service authorizations, over and under utilization.
11. Assists with monitoring the centers' appeals and denials process; assists with monitoring fairness, equity and cost effectiveness of all services provided.
12. Ensures the provision of and adherence to Center related abuse, neglect, rights, program complaints & related investigative processes.
13. Provides back up to the MH or IDD Rights Protection Officer as needed; serves as back up liaison to the Texas Department of Family and Protective Services (DFPS) as needed.
14. Ensures the provision and adherence to the Center's appeals and Medicaid Fair Hearings process as required; conducts all assigned investigative processes according to center policy, procedure and related rules; completes and processes all related documentation within two business days of receipt.
15. Ensures current postings of all applicable related information at each Center operated/contracted facility or residential programs as required.
16. Attends and advocates as appropriate and requested on behalf of a person served within established rules and regulations.
17. Provides abuse, neglect, rights and confidentiality (ANRC) training as scheduled
18. Coordinates internal crisis services satisfaction surveys in accordance with applicable rules and regulations, performance contracts and the center's current policies and procedures; compiles all results in a historical worksheet to track trends and make reports available to supervisor on an annual basis and as needed.
19. Conducts follow-up surveys with consumers to ascertain outcome achievement and satisfaction as part of the quality.
.
20. Participates in the Center's Zero Suicide Initiative.
o Supports individuals experiencing a crisis by promptly connecting them with appropriate Center programs, such as the Mobile Crisis Outreach Team (MCOT), Psychiatric Triage, Crisis Prevention services, and/or other applicable resources. Ensure seamless coordination to facilitate timely intervention.
o Remains with individuals, when deemed safe, to provide support and maintain a calm environment until specialized crisis staff or emergency personnel arrive to take over intervention efforts. Adheres to safety protocols to prevent escalation of the crisis situation.
o Participates in debriefing sessions with the immediate supervisor or designated staff following a crisis event. Collaborate with the team to review the incident, identify lessons learned, and ensure all HHSC guidelines and Center policies are followed.