Behavioral Health Clinical Quality Audit Analyst Senior

Full-time - Mid Level

Atlanta, GA

Ambulatory Health Care Services

About the position

The Behavioral Health Clinical Quality Audit Analyst Senior (Quality Assessor) is responsible for participating in on-site quality external audits and prepares audits of required documents. Will work within the Quality Management Department and the Georgia Collaborative. Will be responsible for conducting quality reviews both on-site at provider locations and remotely. Candidates must be able to travel within the state of Georgia (25-30%).

Responsibilities

• Provides recommendations for quality improvement studies including selection of valid and reliable indicators and coordinates monitoring and evaluation activities upon select implementation.
• Analyzes data and prepares concise, accurate and meaningful quality management reports in accordance with Company procedures.
• Defines opportunities for improvement through trend analysis and communicates information appropriately.
• Performs monthly, quarterly, annual and ad hoc medical record reviews.
• Conducts quality of care investigations and using criteria closes case appropriately or refers to BH Medical Director for further review.
• Travels to worksite and other locations as necessary.
• Conduct contract-required quality record reviews to ensure providers' compliance with policies, state and federal standards, participate in other monitoring assignments, as required.

Requirements

• Requires MS/MA degree in behavioral health or related field.
• Minimum of 3 years experience in quality improvement and/or behavioral health, risk management and/or utilization review in a managed care setting.
• Any combination of education and experience which would provide an equivalent background.

Nice-to-haves

• Licensure in a mental health related field (Ph.D., RN, LCSW, LPC, LMFT, LMSW etc.) is preferred.
• Experience in behavioral health is preferred.
• Experience with quality improvement philosophy and techniques and state, federal guidelines and regulations preferred.
• Experience with treatment record documentation or some clinical experience with quality related treatment record documentation preferred.
• Experience working with Georgia DBHDD Provider Manual preferred.

Benefits

• Merit increases
• Paid holidays
• Paid Time Off
• Incentive bonus programs
• Medical, dental, vision benefits
• Short and long term disability benefits
• 401(k) + match
• Stock purchase plan
• Life insurance
• Wellness programs
• Financial education resources