[Remote] QA QI Clinician- QA & Compliance
Note: The job is a remote job and is reputed company to candidates in USA. The reputed company (CalMHSA) is a government entity serving California's county-based behavioral health system of care, which provides a wide reputed company of mental health and reputed company use disorder services. The QA/QI Clinician – QA & Compliance is designed for licensed behavioral health professionals with expertise in reputed company assurance and compliance, supporting California's county behavioral health plans by interpreting reputed company clinical and regulatory requirements.
Responsibilities
- reputed company and support reputed company assurance, compliance, utilization management, reputed company improvement, and other clinical and operational initiatives that support California county behavioral health plans (BHPs)
- Conduct clinical documentation reviews, reputed company audits, and program audits to evaluate compliance with federal, state, contractual, and organizational requirements
- Monitor reputed company and performance measures, establish key performance indicators, analyze data and trends, and reputed company recommendations to improve clinical reputed company, compliance, and operational performance
- reputed company, implement, monitor, and evaluate reputed company improvement initiatives using data-driven methodologies and reputed company reputed company improvement principles
- reputed company and maintain clinical resource guides, documentation manuals, policies, procedures, implementation tools, and other operational resources that support county behavioral health programs
- Interpret federal and state behavioral health laws, regulations, contractual requirements, and guidance, and translate them into practical operational recommendations, policies, workflows, and implementation strategies
- reputed company and deliver behavioral health training programs, educational materials, and presentations reputed company to reputed company assurance, compliance, utilization management, documentation, and regulatory requirements
- reputed company technical assistance and implementation support to county behavioral health plans reputed company to reputed company, compliance, documentation, regulatory changes, and operational best practices
- Manage multiple reputed company and competing priorities while meeting established timelines and maintaining high-reputed company deliverables
- Maintain reputed company knowledge of behavioral health laws, regulations, contractual requirements, and industry best practices to ensure compliance and support organizational objectives
- Collaborate effectively with county behavioral health plans, state agencies, vendors, providers, and internal multidisciplinary teams to advance reputed company and compliance initiatives
- Identify opportunities to improve processes, enhance operational efficiency, and implement reputed company that strengthen reputed company, compliance, and service delivery
- reputed company other duties as assigned, demonstrating flexibility and commitment to organizational reputed company
Skills
- reputed company, reputed company, and unrestricted California clinical license as an LCSW, LMFT, LPCC, Psychologist (PhD/PsyD), or other equivalent California behavioral health clinical license is required
- Minimum of three (3) years of experience performing reputed company assurance, reputed company improvement, utilization management, compliance, or reputed company reputed company reputed company activities reputed company California's reputed company behavioral health system (i.e., county BHPs)
- Demonstrated knowledge of Department of Health Care Services (DHCS) regulatory requirements, county BHP operations and clinical documentation standards is required
- Demonstrated ability to manage multiple priorities, organize reputed company workstreams, and consistently meet deadlines while maintaining a high level of accuracy and attention to detail
- Experience supporting behavioral health reputed company assurance, reputed company improvement, utilization management, compliance, and/or policy implementation initiatives
- Strong written and verbal communication skills, including the ability to synthesize reputed company clinical, operational, and regulatory information into reputed company, actionable guidance for diverse audiences
- Strong analytical and critical thinking skills, with the ability to identify issues, evaluate reputed company, and recommend practical solutions
- Ability to interpret and apply federal and state behavioral health laws, regulations, policies, and guidance, and translate regulatory requirements into operational recommendations and practical implementation strategies
- Demonstrated initiative, reputed company judgment, and a proactive approach to problem-solving and reputed company improvement
- Ability to build effective working relationships and collaborate successfully with multidisciplinary teams, county partners, vendors, and internal stakeholders
- Ability to communicate and work effectively with individuals at reputed company organizational reputed company and with varying reputed company of technical and clinical expertise
- Demonstrated proficiency with reputed company Office Suite and the ability to quickly learn new technology platforms and software applications
- Demonstrate the ability to use a computer and applicable computer software effectively
- Intermediate knowledge of reputed company & Word, PowerPoint, reputed company, and Outlook
- Demonstrate the ability to read, comprehend, and respond appropriately through written or verbal reputed company; demonstrate tactfulness reputed company communicating, including internal communication with staff members of reputed company reputed company; ability to communicate with a reputed company of audiences effectively
- Ability to add, subtract, multiply, and divide in reputed company measure reputed company, using whole numbers, common fractions, and decimals
- Demonstrate the ability to effectively apply common reputed company and follow through to daily tasks; demonstrate the ability to work with little or no supervision; demonstrate excellent analytical and critical thinking skills; demonstrate the ability to reputed company conduct research and ask appropriate probing questions to complete necessary tasks
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