Clinical Quality Assurance Analyst I
Clinical Quality Assurance Analyst I
Join Southwest Behavioral & Health for exceptional growth opportunities driven by our promote-from-within philosophy. We provide an EXCELLENT compensation and benefits package, including immediate participation in our 403(b) program with 20% company match after 1 year of service. Generous Paid Time Off (PTO) includes 3 weeks of time-off your 1st year (available after 6 months) and increased vacation accruals after 2, 5 and 10 years of service! We offer low cost medical insurance and offer 100% company-paid dental, Short Term Disability, Long Term Disability, and Life coverage for employees. Other great benefits include 10 paid holidays, vision, licensure/certification reimbursement, tuition reimbursement, prescription drug discounts, chiropractic services, 100% paid Employee Assistance Program, and much more!
Southwest Behavioral & Health Services is a large and growing, non-profit community-based provider of behavioral health services with locations throughout the Phoenix metropolitan area, rural Maricopa County, Gila, Pinal, Mohave, Coconino, and Yavapai Counties. We are a well-established voice in the community with more than 115 sites, over seven hundred employees, and 40 years’ experience.
We are seeking a Clinical Quality Assurance Analyst to complete internal auditing, training, and clinical quality assurance management. This position will be responsible to analyze, track, report and follow up on quality management and compliance issues as well as be a clinical support for staff through training and attention to clinical documentation issues. This position is a full-time exempt position working 40 hours per week in our Administration Building located in Phoenix.
Duties & Responsibilities:
- Manage and schedule quarterly internal quality audits for all residential programs company-wide for quality and compliance.
- Initiate audit reports and distribute to Program Coordinator, Director and VP of the programs.
- Performs collections, compilation, analysis and reporting of assigned quality metrics.
- Assist the Chief Compliance Officer in investigation of internal or external quality related events.
- Verify corrective and preventative actions are in place and work as part of the internal audit process.
- Conduct trainings to all staff as needed in collaboration with the QM/UM and Compliance department staff.
- Assist with external QM/UM review and audit processes.
- Develops and implements clinical quality improvement plans.
- Analyzes, tracks, and reports general trends in documentation.
- Collects and tracks quarterly program internal audit data.
- Communicates with RBHA, Health Plans and funding sources regularly to clarify documentation requirements, content and outcomes.
- Communicates changes in clinical record requirements to staff and supervisors.
- Prepares summary reports, recommendations, and presentations for Corporate Compliance Officer, SBH leadership and other committees as needed.
- Maintain knowledge of current and potential new and revised regulations and standards.
- Participates in the organizations accreditation readiness activities and onsite surveys.
Education & Qualifications:
- Bachelor's Degree in Behavioral Health or related field, plus 2 years of directly related experience required.
- Equivalent combination of education and direct experience will be considered.
- Prior working experience that lends to clinical quality management and sufficient experience in clinical records documentation requirements.
- Working knowledge of AHCCCS billing, AHDS licensure, and T/RBHA clinical documentation and program requirements.
Job Reference #: 4664