Behavioral Health Quality Assurance Specialist

Behavioral Health Quality Assurance Specialist Job Description

Our Mission: 

The Black Mental Health Corporation strives to provide excellent, quality mental health care to underserved communities. It is the goal of The Black Mental Health Corporation to rebuild these communities, one family at a time through excellent mental health, community based and social assistance services.

Our History: 

TBMHC was created by founder Desmond YanaMayu with black people in mind, after realizing this diverse population experiences challenges and struggles that are unique from many other racial/ethnic groups. Because of this, he wanted to create a space where black people could feel comfortable getting counseling with someone who understood their issues. Even still, The Black Mental Health Corporations services are open to people of all ethnicities and racial backgrounds.

Join us at The Black Mental Health Corporation, where we strive to create a supportive environment for all individuals, with a special focus on the unique challenges faced by the Black community. We welcome candidates from all ethnicities and backgrounds who are committed to making a difference in the lives of children, adolescents, and families.

Values:

T – Transparency

We operate with honesty, openness, and integrity in every interaction—with our clients, our team, and our community. We believe trust is built through clear communication and ethical practices.

B – Belonging

We create safe spaces where clients and staff feel valued, seen, and respected. We honor the lived experiences of Black individuals and all marginalized communities, fostering an environment of inclusion and cultural humility.

M – Mission-Driven

Every decision we make is rooted in our mission to provide high-quality, culturally responsive mental health care. We are committed to empowering individuals, strengthening families, and uplifting our community.

H – Healing-Centered

We approach our work through a healing-centered lens—acknowledging trauma, celebrating resilience, and supporting holistic wellness for clients and team members alike.

C – Collaboration

We believe that collective impact is greater than individual effort. We build strong partnerships within our organization and the community to provide the best possible care and promote mental health equity.

Job Summary:

As the Behavioral Health Quality Assurance Specialist, you will monitor compliance in the Agency through audits, checklists, and continuous quality improvements. The Quality Assurance Specialist maintains current information on clinical practice guidelines, health tech assessments, policies, and recommendations for expert behavioral health practices; maintains a policy library; develops, coordinates, and implements testing and quality assurance measures and activities; monitors testing and quality assurance policies, processes, and procedures; and prepares and submits reports and deliverables on time as required. Design, develop and oversee the QA committee, all quality monitoring activities and auditing of client charts, notes, intakes, and assessments. Provide quality measures and how they apply to the various Behavioral Health departments and act as an operational compliance monitor for the Agency. Work closely with and in consultation with the Clinical Director and leadership staff. Support overall consistency, thoroughness, and compliance with OHMAS and CARF standards. 

Responsibilities:

• Plans, coordinates, and directs quality assurance programs designed to ensure continuous quality of care consistent with established standards and customer requirements and expectations.
• Oversees and facilitates all QA activities, provides continuous improvement updates and consulting services to internal staff to increase knowledge of performance improvement, strategies, principles, methodology, techniques, and data analysis.
• Ensures accurate clinical reviews and determinations through accurate assessment of the patient, relevant evaluations, and collateral sources of individuals.
• Establishes key performance indicators and maintains systems for tracking, reporting, and improving performance.
• Reviews audit results and identifies the severity of findings or the risk associated with the findings to ensure the appropriate level of action is taken to eliminate non-conformance.
• Tracks or follows up on corrective action plans to ensure completion of all items in the specified time frame.
• In collaboration with the Practice Manager, reviews and evaluates reported crisis (i.e., highly urgent service-related problems with immediate negative implications for the Company) and formulate a plan of action for handling the incident/issues based on the area of expertise/responsibility.
• Attends and actively participates in staff meetings and conducts case consultations/peer reviews/internal auditing.
  Performs ongoing reassessment of the review process to offer opportunities for improvement and/or change.
• Facilitates and supports Stakeholder Advisory Councils.
• Utilizes measurable indicators and outcome measurements to determine whether the desired organizational results are achieved.
• Consistent reviewing clinical notes for timely completion, medical necessity, and meeting the standard of care.

Required Qualifications

• A masters Degree in Psychology or Social Work-related health care discipline is Preferred.
  
• Ability to work independently, exercise good judgment, perform clerical work in a methodical independent manner with speed and accuracy.
• Ability to provide information in verbal and written form professionally
• Knowledge of quality improvement techniques and evidenced-based practices preferred
• Experience in project management, program evaluation, team facilitation, and analysis preferred
• Experience in Behavioral Health programs, healthcare field, or health plan quality management, data analytics, public health, or closely related field preferred
• Ability to determine a clinical diagnosis accounting for psychological and behavioral issues.
• Ability to utilize computer equipment and web-based software to conduct work.
• Ability to interact with the various office staff as needed to support necessary workflows.
• Ability to interact with healthcare professionals, patients, their families, and other supports.
• Ability to communicate effectively to individuals and groups through spoken, written, and electronic media.
• Ability to attend to detail, effectively prioritize and execute tasks in a timely manner.

Experience

• Minimum of 2 years of Quality Assurance experience in a Behavioral health-related field.
  Experience in auditing and reviewing clinical notes.
• Knowledge and experience of psychiatric disorders, symptoms, diagnoses, and criteria as defined by the most current Diagnostic and Statistical manual. Quality management and/or compliance experience required.
• Experience identifying organizational needs and recommending the appropriate improvements to increase organizational effectiveness.
• Knowledge of Parity in Mental Health
• Knowledge of insurance programs with relevant experience navigating similar complex projects.
• Knowledge of standards of practice related to the determination of Level of Care.
• Knowledge and understanding of public sector services and supports.
  
• Computer proficiency in Microsoft Excel, Word, PowerPoint, Google Workspace, & Athena. 
• Ability to determine a clinical diagnosis accounting for psychological and behavioral issues
• Utilize computer equipment and web-based software to conduct work. 
• interact with the various office staff as needed to support necessary workflows, interact with healthcare professionals, patients, their families, and other support systems, communicate effectively with individuals and groups through spoken, written, and electronic media.
• Ability to attend to detail, effectively prioritize and execute tasks in a timely manner.