Quality Assurance Specialist-Part Time 20 Hours/ Week

JOB SUMMARY

The Quality Assurance (QA) Specialist position is a part time, up to twenty (20) hours per week hybrid (remote and on site) position. This position requires an individual with a passion for attention to detail, identifying patterns, problem solving, and ensuring ethical standards are maintained. This position requires an individual who is thorough, accurate, can prioritize and take initiative to address issues as well as complete tasks efficiently. This position requires a person who excels in being able to work independently to provide quality, easy to understand feedback for areas of improvement in documentation to clinic team members as well as provide accurate reports to the Program Manager. The QA Specialist must be knowledgeable and stay abreast with San Diego County documentation compliance standards, the CalAIMS initiate, and Short-Term Residential Therapeutic Program (STRTP) compliance standards. The QA Specialist completes weekly billing and full clinic chart audits, provides documentation training and support to clinic team members, as well as annual Medical Record Reviews (MRR) and Department of Health Care Services (DHCS) audits. This position ensures services are documented and coded accurately, makes billing corrections when needed, and completes compliance activities according to applicable regulatory and accrediting entities.

REQUIRED MINIMUM QUALIFICATIONS

EDUCATION/ EXPERIENCE:

A qualified candidate must possess one (1) or more of the following:

• Minimum two (2) years’ experience working within a Child, Youth and Families (CYF), San Diego County contracted Behavioral Health Services (BHS) program, documenting and/or auditing Behavioral Health Assessments (BHA), Client Plans, and outpatient services in Cerner/CCBH.
• Working knowledge of how to navigate San Diego County's electronic health record (Cerner/CCBH).
• Working knowledge of how to navigate the Optum website to locate appropriate program forms, documentation, and billing resources.
• CA license eligible or licensed Clinical Social Worker, Professional Clinical Counselor, Marriage and Family Therapist, or Psychologist.
• Knowledge of Medi-Cal billing, STRTPs, and San Diego County's documentation compliance requirements.
• Ability to run, read, analyze, and interpret clinical records and Cerner/CCBH reports, define problems, collect data, establish facts, and draw valid conclusions.
• Master's degree in social work, counseling, psychology, or related health services or equivalent education.