Job Title: Quality Assurance Auditor
Major Functions :
In concert with the agency’s mission and goal of sustaining high quality care/service delivery to persons served, the Quality Assurance Auditor works to assist managers and supervisory staff with assuring compliance with external and internal utilization review/quality and appropriateness requirements.
Specific Duties and Responsibilities :
Job Requirements :
- Conducts timely scheduled/required utilization reviews for Ambulatory Services sites.
- Conducts timely and complete quality and appropriateness reviews on a representative sample of treatment records for ambulatory and residential service sites.
- Attends monthly/other required ambulatory QA Committee meetings. Prepares accurate and timely QA Committee minutes and required monthly and/or quarterly reports. Participates in the agency’s Quality Improvement / Utilization Management Committee.
- Timely aggregation and report writing quality and appropriateness record reviews for the Client Services Quality Improvement and Utilization Management Committee.
- Monitoring and evaluating activities and report writing for incident data.
- Assists with the maintenance of the agency’s CARF accreditation for its Methadone-to-Abstinence program’s, i.e., standards review and conformance auditing.
- Performs other duties as assigned.
1. Working knowledge of quality assurance and utilization review systems
2. Computer proficiency (Word, Excel)
3. Strong time management skills
4. Ability to work independently
5. Strong report writing skills
1. Bachelor’s degree or higher
2. Minimum of two years clinical or quality assurance experience in behavioral healthcare/human services organization
3. Knowledgeable about HIPAA and 42 CFR regulations