Job Description
Clinical Quality Analyst
Remote, United States
About the Role
Our team is comprised of passionate, forward-thinking professionals eager to take on the challenge of the mental health crisis and play a formative role in providing life-saving solutions. We are looking for a candidate who is inspired by our mission and excited by the opportunity to build a business that will impact millions of lives in a profound way.
The Clinical Quality Analyst is responsible for ensuring quality medical and clinical processes are conducted in accordance with company, industry, accreditation, state, and federal guidelines. This person will perform and manage quality assurance and clinical audits related to medical and clinical functions for quality, accuracy, and consistency to ensure an efficient process. This person will be familiar with company policy and be able to develop and constantly evaluate workflow procedures to ensure documentation compliance. This position assists with the development and maintenance of system policies and procedures, knowledge base and system improvements.
Responsibilities
- Audit assigned records daily
- Lead and/or participate in implementation of quality improvement processes
- Assist in developing cross company documentation procedures to meet clinical compliance
- Provide consistent application of the audit criteria
- Maintain high level of confidentiality relating to audit reviews and audit findings
- Based on audit findings, provide education and feedback for opportunities for improvement
- Collaborates with administration and other departments to develop the most effective interdepartmental procedures
- Notifies Quality and Safety Manager in matters relating to the integrity of the medical record
- Provides direct support to clinical team to implement quality improvement initiatives
- Submit medical records as requested within timely manner
- Managed assigned productivity
- Participate in special projects
- Completes monitoring reports to summarize results and findings. Conducts Action Plan follow-ups as required and within required timeframes
- Any and all other duties related to the position as assigned
- Provide accurate reporting on compliance initiatives
- Provide accurate reports to Dir. of Quality, Safety, and Compliance Operations upon request
- Will participate in State, Medicaid and accreditation Survey preparedness initiatives
- Assist with Incident Reporting, Tracking and Investigation Procedures
Requirements
- 2+ years of experience in healthcare auditing
- Bachelors or master’s degree in behavioral health or nursing field preferred
- Healthcare or behavioral health operations experience preferred
- Strong knowledge of state and federal statutes regarding patient confidentiality laws
- Knowledge of ASAM criteria
- Knowledge of mental health recovery model and LOC guidelines
- Knowledge of behavioral health guidelines or assessments, treatment plans, and LOC
- Knowledge of The Joint Commission Behavioral Health Standards
- Ability to work with sensitive and/or confidential information
- Proficient in Microsoft Office, especially Word & Excel.
- Basic understanding of applicable laws, regulations, industry standards, and related compliance issues, particularly regarding The Joint Commission and State accreditation
- Exhibits a comprehensive understanding of healthcare regulatory and compliance (HIPAA)
- Ability to function independently with minimal supervision