What are the responsibilities and job description for the Quality Review Specialist - Auditing - Miami County position at 4C Health?
Job Details
Description
Join a leader in community mental health with a vision for the future…that sets the pace for associate self-care! Learn about 4C’s 4-day, 32-hour work week by clicking below.
https://www.youtube.com/watch?v=Aymn0x7fsCQ
New minimum wage raised to $18.75/hour!!
Why work for less? Come make a difference with us, 4C Health continues to grow, and we are looking for agile staff committed to caring for our consumers, communities, and each other! 4C Health is a non-profit, comprehensive Community Mental Health Center serving the communities of North Central Indiana for over 45 years. We are rural behavioral health specialists integrated in the physical and behavioral health well-being for our staff and consumers. Our workforce is the heartbeat meeting the needs of our local communities, don’t wait to join our team!
POSITION SUMMARY:
This position is responsible for coordinating and conducting all internal audits and assisting in preparation of external audits to ensure that the Center’s focus of quality client care is achieved. A person in this position will focus on the master audit plan of the Center. A person in this position must have an understanding of state and federal requirements including a clear understanding of Medicaid regulations. This position operates under minimal supervision and must exercise tact, judgment and confidentiality in contact with the public, clients and families, as well as fellow associates of the Center. Work is very broad in scope and requires a high level of professionalism.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
- Demonstrate an understanding of state and federal regulations; including Medicaid.
- Demonstrate the ability to complete audits within the agency as outlined in the master audit plan.
- Demonstrate the ability to gather necessary information and present to the Lead Auditor.
- Evaluate and assist in the development of audit tools and processes relating to quality across the Center.
- Conduct internal Center audits including but not limited to GIRPP notes, OP charts, BPHC, DMHA (CAP), CANS/ANSA and/or risk assessments and others as identified.
- Assist in the Center’s preparation for external audits (such as DMHA, BPHC/AMHHI, Payee, DCS, etc.) as requested by the Lead Auditor. This will include attending all Center audits to provide relevant documentation and information, track audit information on applicable spreadsheets, and assist the VP in reviewing and implementing CAP for all audits.
- Identify concerns and develop a plan to address and correct areas of need with the assistance of the Lead Auditor.
- Coordinate amendments to the Electronic Health Records (EHR) systems and processes.
- Identify, attend and participate in trainings relative to position; internal and external.
- Respond to client complaints; including contacting the client, investigating the complaint, contacting the supervisor and contacting the client with a resolution and/or close complaint.
- Maintain positive internal customer relations and collaborate with those customers to implement continuous quality improvement techniques and philosophy.
- Train newly hired Center associates as requested by the Lead Auditor.
- Abide by all Center policies and procedures.
- Maintain positive working relations and rapport with the communities served.
Starting and growing base wage opportunities up to $20.25/hour!!
PLUS. Additional Annual Compensation and Incentive Opportunities!!
- Four-day (32 hour) work week
- Eligible for $150/month ($1,800 annually) in student loan repayment, available at hire
- Earn $750 for every person you refer who is hired and remains employed for 6 months and receive an additional $500 every year as long as you both remain employed
- Bilingual wage premiums available for individuals fluent in Spanish or Burmese
Benefits:
- Multiple health plan options to fit your lifestyle
- Health premium wellness discounts
- Employer paid HSA contributions
- Mileage reimbursement
- Dental and Vision
- 403(b) retirement plan
- Employer paid life insurance and other supplemental insurance products to choose from
- Up to $10,000 in tuition assistance
- Birthdays off after 1 year of employment
To see our full benefits and apply online go to our website: www.4CHealthIN.org
Qualifications
REQUIREMENTS:
Education:
- High School Diploma Required.
- Associates and/or Bachelors degree preferred.
Experience:
- At least 1 (one) year of experience in the mental health field required.
Necessary skills:
- Works well under supervision as well as independently. Organizes/manages time and daily activities with little direct supervision.
- Ability to think critically and analyze information/situations for most appropriate response.
- Strong organizational skills and detail oriented.
- Handles complex tasks and requests supervision when necessary.
- Able to utilize databases and/or other electronic means to perform duties.
- Models professionalism, teamwork and communication internally and externally.
- Maintains positive working relations and rapport with the community.
4C Health is an Equal Opportunity Employer and committed to creating a diverse and inclusive environment. 4C Health does not discriminate against candidates or employees because of disability, sex, race, gender identity, sexual orientation, age, veterans status, or any other protected status under law.
Salary : $500 - $1,800