Quality Assurance Clinician

Awareness of Regulations

• Researches information for compliance with local, state, and federal regulations as needed and directed.
• Maintains working knowledge of contracts, program standards and policies as developed by Five Acres, Community Care 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, and participating in in-service programs.
• Participates in Service Area Quality Improvement Committee (QIC) meetings sponsored by DMH; informs appropriate Agency personnel regarding updates and issues.
• Maintains documentation of quality assurance activities; collaborates with other mental health or social service agencies.

Audit Requirements

• Recommends and assists in writing policies and procedures to facilitate communication and adequate information flow to improve quality assurance and compliance issues.
• Reviews documents for quality, required information, signatures and deadline compliance as required by funding source contract; reports findings to program staff, supervisors, and QA team.
• Oversees organization of records for visits and audits; reviews and corrects audit instruments; and prepares audit reports as needed.
• Coordinates all QA review processes (Peer Review and Utilization Review processes) to ensure compliance with DMH, COA, and other regulatory agencies; works collaboratively with the QA team on the compilation and reporting of the outcomes data to Programs within a timely manner.
• Conducts periodic internal audits of client case records with a focus on documentation compliance including meeting timelines, accuracy and quality, and medical necessity.
• Integrates the findings of external review processes, including licensing reviews, information related to compliance with federal, state, and department requirements, governmental audits, accreditation, and other reviews into the agency's Continuous Quality Improvement (CQI) process, where appropriate.
• Maintains records of internal audits and necessary follow up for reporting to the CQI Committee; assesses audit results for trends and training needs and reports findings; compiles quarterly reports of overall agency documentation compliance to Senior Leadership.
• Works collaboratively with the QA team to analyze audit findings for both contracts; identifies trends and makes system recommendations where appropriate to Program Directors, Supervisors, and Providers.
• Makes regular visits to all program sites to observe activities for quality assurance purposes; interfaces with program staff about quality assurance issues.
• Organizes, implements, and ensures quality training of staff in DMH and DCFS documentation requirements.
• Ensures all QA staff complies with the legal mandates of HIPAA for client confidentiality and release of information.

Compensation Range: $69,333/yr - $107,467/yr

Work culture matters at 5A! We offer a comprehensive benefits package with a medical coverage option as low as $5 with free dental HMO, vision, life insurance, AD&D and disability insurance. We offer a 401k with an annual match up to 3%, annual performance reviews with up to 4% merit (6% for direct service providers), plus annual retention stipends. We offer team building retreats, wellness incentive, 12 paid holidays and flexible work schedules, including remote options for identified positions!