DUTIES

SUMMARY

The Clinical Quality Assurance Coordinator uses independent judgement and discretion to perform complex program reviews and analysis that support contract compliance and program performance, adhere to chart and program documentation requirements, program reporting and preparation for agency audits. Ensures compliance with legal, ethical, contractual and agency requirements and standards.

ESSENTIAL DUTIES

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Analyzes and evaluates charts, summarizes and shares findings with appropriate supervisors and managers, and leadership.

• Acts as primary liaison with Department of Mental Health’s (DMH) Standards and Records Department and internal mangers for other funders relative to documentation issues.

• Identifies clinical staff in need of chart documentation training; develops training material and conducts training for managers, supervisors, and staff.

• Prepares for audits utilizing the Electronic Health Record System (EHRS) and claiming system at an expert level and collaborates with VP’s, Director of Compliance, Clinical Program Managers, Supervisors, Health Information Management (HIM), Custodian of Records, and leadership for audit purposes.

• Analyzes and evaluates documentation for accuracy of clinical content and procedure billing codes for DMH Contracts.

• Develops and implements tracking forms and systems in order to audit chart documentation to federal and county regulations; identifies and recommends methods to streamline procedures/improve efficiency.

• Acts as primary liaison with DMH Standards and internal department’s Director of Compliance, HIM, Custodian of Records Department, and other funders relative to documentation issues.

• Collaborates with VP’s, clinical managers, and supervisors to prepare for audits by DMH, Department of Child and Family Services, and other funders.

• Serves as leader in such audits. Maintains working expert knowledge of program standards and policies as developed by the agency, licensing and other governing bodies.

• Develops personal and professional knowledge by attending educational workshops; reviewing professional publications; establishing personal networks; benchmarking state-of-the art practices; participating in in-service programs.

ADDITIONAL DUTIES

• Other duties and special projects as assigned.

SUPERVISORY RESPONSIBILITIES

• This job has no supervisory responsibilities.

QUALIFICATIONS

EDUCATION & EXPERIENCE

• 3 years of County and State standards to chart documentation experience.

• Master's degree in psychology, social work, marriage and family counseling and registration or license required.

OTHER QUALIFICATIONS

• Possesses a valid driver's license and state-required auto insurance or reliable transportation depending on business needs.

• Required to travel extensively (> 50% of the time).

• Ability to work with minimal supervision.

• Ability to handle confidential information. 

• Maintains patient privacy, including protecting the confidentiality, safeguarding the integrity and availability, and limiting the use and disclosure of patient Protected Health Information (PHI) to authorized individuals and entities.

• Participates in, conducts, and sustains performance quality improvement activities according to designated role and responsibilities.

• Sensitivity to service population’s cultural and socioeconomic characteristics.

• Excellent verbal and written communication skills.

• Punctual and dependable attendance.

• Free from alcohol and drug abuse.

• Understands CII’s basic philosophy and participates fully in carrying out its mission.

CERTIFICATES, LICENSES, REGISTRATIONS

• Any of the following:

• MFT Associate Registration with the Board of Behavioral Sciences.

• MFT License with the Board of Behavioral Sciences.

• LCSW License with the Board of Behavioral Sciences.

• ASW Registration with Board of Behavioral Sciences.

• Registered and Waivered with the Board of Psychologists.

COMPUTER SKILLS

• Must have advanced knowledge proficiency of computer programs in a Windows environment, including Word, Excel, PowerPoint, Outlook, and Teams.

• Proficient in Electronic Health Records System

VISION REQUIREMENTS

• No special vision requirements.

NOISE LEVEL

• Moderate noise

REQUIRED TRAINING

• New Hire Orientation

• AB-1343: Sexual Harassment Prevention training

• Mandated Reporter

• Timekeeping & Attendance

COMPENSATION:

In accordance with California law, the expected pay range for this position is included in this posting.  The actual compensation will be determined based on factors permitted by law. New hires will be offered a salary at the starting point of the range to maintain internal inequity and allow opportunity for future salary growth. CII salaries are determined based on comprehensive internal and external market analysis, as well as the skills, education, and experience relevant to each position.

BENEFITS: 

• Generous paid PTO, plus 10 paid holidays and CII is closed between Christmas and New Year 

• Excellent medical, dental, and vision insurance for eligible employees and qualified dependents

• 403b Retirement Plan with employer contribution for eligible employees

• Up to $4,500 in tuition reimbursement per calendar year

• Eligible for the Public Service Loan Forgiveness program 

• Flexible Spending Account (FSA) & Health Savings Account (HSA)

• Employer paid Life and AD&D Insurance 

• Voluntary Supplemental Insurance 

• Opportunity for growth & advancement 

• Professional development & continued training 

• Team building & bonding through company sponsored events & activities

CONTINGENCIES: 

• Influenza immunization or declination

• COVID-19, MMR and Tdap immunizations

• Education verification

• Reference check

• Background fingerprint clearance (FBI, DOJ, CACI) conducted by the California Department of Social Services 

• Drug and alcohol screening

• Tuberculosis screening