Quality Assurance Auditor (Behavioral Health)

PATH BEHAVIORAL HEALTHCARE JOB DESCRIPTION 

TITLE: Quality Assurance Auditor (Behavioral Health)

REPORTS TO: Chief Compliance Officer 

WORK AREA: Remote or Hybrid Ohio

 SUMMARY:  We are seeking a highly motivated and detail-oriented Quality Assurance (QA) Auditor to join our team at PATH Behavioral Healthcare. The QA Auditor will play a critical role in evaluating and ensuring that our services, processes, and documentation comply with internal standards, external regulatory requirements, and industry best practices. The ideal candidate will have a deep understanding of behavioral health practices, an eye for detail, and a commitment to continuous improvement.

 BLOODBORNE PATHOGEN CATEGORY I: Tasks with actual blood/body fluid exposure are not included in this position’s duties. 

  PRIMARY JOB DUTIES:

• Audit and Review: Conduct comprehensive audits of clinical documentation of therapists and case managers and patient records to ensure compliance with company policies, regulatory standards, and industry best practices.
• Compliance Monitoring: Assess adherence to state, federal, and accrediting body standards such as those set by Medicaid, CARF, HIPAA, and others, ensuring that all services meet required standards of care.
• Data Analysis and Reporting: Compile audit findings into clear and actionable reports. Present findings to leadership and recommend areas for improvement or corrective action plans.
• Process Improvement: Ensure that corrective actions are implemented effectively and efficiently.
• Training and Support: Provide support and guidance to staff on documentation standards, compliance procedures, and best practices in behavioral health services. Conduct training sessions as needed.
• Continuous Monitoring: Regularly monitor the effectiveness of implemented corrective actions and verify ongoing compliance through follow-up audits.
• Confidentiality & Ethics: Ensure that all audits and investigations are conducted with strict confidentiality, in accordance with HIPAA and other privacy regulations.
• Stay Updated: Keep up to date with changes in healthcare regulations, quality standards, and best practices in the behavioral health industry.

 EDUCATION:

• Bachelor's degree in healthcare, social work, psychology, or a related field.

QUALIFICATIONS:

• Minimum 2-3 years of experience in a Quality Assurance or auditing role, preferably within a behavioral health or healthcare setting.
• Strong knowledge of behavioral health services, regulatory standards, and compliance requirements.
• Familiarity with electronic health records (EHR) systems and data management.
• Excellent analytical, problem-solving, and organizational skills.
• High attention to detail with the ability to identify discrepancies and non-compliance issues.
• Ability to communicate findings clearly, both verbally and in writing.
• Strong interpersonal skills, with the ability to work effectively with various stakeholders, including clinical staff and management.
• Proficient in using auditing tools and software, as well as MS Office Suite.

WORKING CONDITIONS:

• Full-time position with potential for occasional travel between company locations.
• Ability to work remotely or in a hybrid capacity may be available depending on company policy.
• This position may require periodic overtime or weekend work depending on audit schedules and deadlines.

Interpersonal Skills: The successful candidate must demonstrate the ability to interact and assist in a friendly, compassionate, and professional manner with colleagues and clients, as they represent both themselves and Path Behavioral Healthcare. 

Background: The candidate must pass all federal and state background checks, and their educational and work history will be confirmed in compliance with company policies.