General Summary: Work collaboratively with Arkansas Quality Management team to review and serve as a professional member of Inspection of Care review teams. Performs clinical onsite Inspection of Care Reviews of providers to ensure they meet regulatory/procedural requirements and possess current State licensure(s) in order to provide quality care to clients.
Essential Duties and Responsibilities:
Reviews beneficiary clinical records to ensure compliance with Medicaid and Arkansas specific rules and regulations.
Writes detailed Inspection of Care reports and documents findings, including documentation of deficiencies where non-compliance exists. Submits Inspection of Care Reports to Quality Manager to include in comprehensive report.
Acts as liaison with providers to ensure that they receive all required materials and documents and are notified in a timely manner regarding any scheduled Inspections of Care.
Travels on almost a daily basis, with some overnight travel required.
Performs special projects and other duties as assigned in order to meet business /departmental objectives.
Education: Master’s degree in Psychology, Counseling, Social Work, or Nursing.
Licensures: Current, valid, and unrestricted State of AR independent licensure as a mental health professional (LMSW, LCSW, LPE-I, LPC, RN) and a valid driver's license.
Relevant Work Experience: Five (5) years’ experience working in a behavioral healthcare environment, preferably in an RSPMI with minimum of three (3) years’ experience working in outpatient behavioral healthcare. Quality Assurance, Quality Management, and/or Quality Improvement related experience in a behavioral healthcare setting preferred.
ValueOptions, a Beacon Health Options company, is a health improvement organization that serves more than 34.2 million individuals. On...