Behavioral Health Quality Assurance Specialist

Ventura County
Full Time 48.98 per per week $71,094 - $109,553 Per year CA Always Best Care Senior Services - Home Care Services in Thousand Oaks, 509 Marin St #227, Thousand Oaks, CA 91360, United States Apply before 5/30/2024 5:00
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Overview



Under general direction of the Senior Manager of Quality, the Quality Assurance Specialist is responsible for operations of various areas of focus to ensure the efficacy of the overall program services, attaining the utmost standards in customer satisfaction, and maintaining all State required quality and legal mandates.

The ideal candidate for this healthcare role possesses a wide understanding of regulatory compliance, quality improvement methodologies, and patient safety protocols. They excel in conducting audits and implementing evidence-based practices to drive measurable outcomes. With strong communication and collaboration skills, they foster a culture of continuous improvement and work effectively with interdisciplinary teams to uphold the highest standards of quality, safety, and patient-centered care. 
 
The Quality Assurance (QA) and Utilization Review (UR) units ensure accurate and appropriate clinical documentation, implements regulatory changes from both the state and federal governing entities, and resolves, tracks, and monitors grievances, appeals and Notices of Actions. This position continually collaborates with Utilization Review staff regarding chart/documentation reviews and to support providers with clinical best practices.

PAYROLL TITLE/APPROXIMATE SALARIES
Staff/Services Specialist I - $34.18 - $48.98 per hour
Staff/Services Specialist II - $36.88 - $52.67 per hour

EDUCATIONAL/BILINGUAL INCENTIVE:  Incumbents may be eligible for educational incentive of 2.5%, 3.5%, or 5% based on completion of an Associate's, Bachelor's, or Master's degree that is not required for the classification. Incumbents may also be eligible for bilingual incentive depending upon operational need and certification of skill.
 
DEPARTMENT/AGENCY:  Health Care Agency – Behavioral Health

Staff/Services Specialist I/II is represented by the Services Employees International Union (SEIU) and is eligible for overtime compensation.

The eligible list established from this recruitment may be used to fill current and future Regular (including Temporary and Fixed-term), Intermittent, and Extra Help vacancies for this position only, There is currently one (1) Regular vacancy.
 
NOTE:  If appointed at the lower level, incumbent may be promoted to the higher level without further examination upon meeting the minimum requirements, demonstrating satisfactory performance, and in accordance with the business needs of the department.
 
TENTATIVE SCHEDULE 
OPENING DATE:  5/9/24
CLOSING DATE:  5/30/24 at 5:00 p.m.

Examples Of Duties

Duties may include, but are not limited to the following:

  • Develops, implements, and monitors quality assurance processes and tools for behavioral health services, ensuring compliance with regulations, best practices, and organizational policies;
  • Oversees audits and reviews clinical documentation, treatment plans, and service delivery to identify areas for improvement and ensure compliance;
  • Provides comprehensive feedback and recommendations to clinical staff and leadership based on quality assurance findings;
  • Monitors and tracks the timeliness of behavioral health services, ensuring prompt delivery and seamless care coordination;
  • Determines medical necessity and appropriate level of care using evidence-based criteria across inpatient, outpatient, and intensive services;
  • Maintains accurate tracking systems for quality assurance activities, utilization review decisions, and outcomes;
  • Generates data reports and analyzes utilization trends and quality metrics to support performance improvement;
  • Ensures compliance with regulatory requirements for documentation, reporting, and client information confidentiality;
  • Provides training and ongoing education to clinical staff on quality assurance principles, documentation standards, and regulatory requirements;
  • Offers guidance and support to clinicians in developing and implementing effective treatment plans aligned with best practices; and
  • Performs other related duties as required.

Typical Qualifications

These are entrance requirements to the exam process and assure neither continuance in the process nor placement on an eligible list.

EDUCATION, TRAINING, and EXPERIENCE:

Considerable progressively responsible operations, project or staff experience related to the reporting level, complexity of work performed, and other requirements leading to the acquisition of knowledge, skills and abilities of the position. At the higher level, some significant related lead, supervisory, project management, grant or contract administration experience may be required.

Staff/Services Specialist I:  Two (2) years of experience in healthcare quality assurance or related activities.

Staff/Services Specialist II:  Four (4) years of experience in healthcare quality assurance or related activities with the ability to plan, organize, and supervise the work of others.

Necessary Special Requirements:

  • Must possess and maintain a valid California driver license as a condition of continued employment
  • Must have intermediate skill with Microsoft Word, Excel, PowerPoint, SharePoint, and Outlook
  • Must have some skill with Adobe Acrobat for form development
  • Must have experience with healthcare policies and procedures
  • Must be able to communicate effectively in writing, demonstrated in the completion of the employment application and supplemental questionnaire responses
DESIRED:
Any one of the following:
  • Licensed Professional Clinical Counselor (LPCC)
  • Licensed Marriage Family Therapist (LMFT)
  • Licensed Clinical Social Worker (LCSW)
  • Psychologist, Registered with the Board of Behavioral Science/Board of Psychology

Knowledge, Skills, and Abilities: 

Working (Staff/Services Specialist I) to considerable (Staff/Services Specialist II) knowledge of:
  • principles and practices of effective supervision
  • the use of automated systems
  • planning, organizing and directing work to meet workload demands
  • project and time management techniques and tools
  • work processes/methods related to the specific assignment
  • budget preparation and monitoring
  • researching and interpreting codes, regulations and policies related to the agency/department and those related to public/customer relations techniques
Working ability to:
  • exercise independent judgment
  • explain department policies and procedures and serve as departmental resource and liaison
  • develop and implement necessary work processes and related procedures
  • perform statistical analysis and data interpretation and reports
  • assist in developing or enhancing office automation applications
  • manage projects, grants or contracts
  • understand the unit's goals
  • draw logical conclusions and make appropriate recommendations or adjustments as needed
  • organize and prioritize work assignments
  • read and interpret technical material
  • complete required forms accurately and completely
Considerable (Staff/Services Specialist II) ability to:
  • plan, organize, and supervise the work of others
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