Quality Assurance Coordinator

Job Description A career with a purpose in the community you love! Salt Lake County invites you to explore our exciting career opportunities. We seek highly enthusiastic individuals to enrich our County with your experience and talent. If you enjoy working in a team environment that is committed to changing the lives of its community, please keep reading. What it’s like to work here: At Salt Lake County, our culture is woven into all aspects of our work and our employees’ lives, from the way we treat each other to the way we support the community. To promote and foster a fun and healthy work environment, we appreciate employees through great benefits, a healthy work-life balance, and room to grow and develop. Surround yourself with: Peers who are motivated to make a difference in the lives of those we serve. We serve Salt Lake County and envision a safe and beautiful place for all to live, work, and have fun. Salt Lake County is about connecting people and championing our community. Our community is more than a place; it's our heart and service that brings us together. We encourage work-life balance: Working for Salt Lake County is more than just a paycheck. A career with us includes several benefits and perks. We support our employees with 12 Holidays, up to 24 vacation days, 12 sick days, and one personal day every year. Some positions have a hybrid work environment, giving you the flexibility to manage working from home and being in the office. Additional Benefits Include: Retirement options for hybrid pension/401(k) or 401(k) only with 10% employee contribution Medical coverage, including a 100% County-paid premium option Dental and Vision coverage with coverage for adult designees Health Savings account with a County contribution of up to $1,200 per year, or a Flexible Spending Account 100% County-paid Long-Term Disability and employee-paid Short-Term Disability options Professional Development and professional membership fees paid Tuition Reimbursement Plus: Onsite medical clinic and gym; hospital insurance, auto insurance, and home insurance, and discounts at County facilities For Benefits information Click HERE To estimate how much your pay and benefits could be worth use our Total Rewards Estimator

JOB SUMMARY

Provides oversight and implementation of mental health and substance use treatment contracts between Salt Lake County and direct service providers. Monitors clinical aspects of agency contracts and audits service providers to ensure adherence to contract requirements, quality of care, and best practices. Reviews Medicaid appeals and makes determinations based on best practices and Medicaid regulations.

MINIMUM QUALIFICATIONS

Master's degree from an accredited college or university in Social Work, Psychology, Marriage and Family Therapy, Educational Psychology, or other closely related field, plus two (2) years of related experience. Current licensure in the State of Utah to practice as a Clinical Social Worker (LCSW), Clinical Mental Health Counselor (CMHC), or Marriage and Family Therapist (MFT). Experience in substance use treatment or mental health treatment and electronic medical records is preferred. Due to the nature of this position, the successful applicant must pass a required background check through fingerprinting and enrollment in the continuous RAP Back (Record of Arrest and Prosecution Back) program in accordance with current County Human Resources policy requirements. A valid Driver’s License accepted by the State of Utah is required at the time of hire. A valid Driver’s License issued by the State of Utah must be obtained within six (6) months of hire to operate a County vehicle.

ESSENTIAL FUNCTIONS

Monitors treatment programs and contractors for compliance with the Division of Behavioral Health's contracts and Clinical Best Practice Standards and performs yearly audits to review performance. Evaluates clinical assessment, admission, and treatment planning information to ensure that services are provided in conformity with Salt Lake County contracts, Department of Health Medicaid, and best practice standards. Reviews treatment program compliance with the Department of Professional Licensing (DOPL) Scope of Practice regulations. Performs site visits at direct service providers’ facilities as part of the auditing process. Compiles and submits annual reports of summations from the auditing process. Provides follow-up on corrective or improvement actions as a result of the audit. Performs pre-admission screening and concurrent reviews on client records to ensure compliance with the utilization review policy. Based on this information, authorizes or denies admission or ongoing treatment. Monitors clinical documentation to ensure that clients receive clinically appropriate services. Reviews medical records submitted during the appeals process to determine the necessity of conducting appeals hearings based on the mental health contractors’ adjudication of claims. Provides training and technical assistance to local contracted treatment providers on documentation methods that accurately substantiate billing practices compatible with Corporate Compliance Standards. Facilitates close collaboration with and between contracted Salt Lake County Behavioral Health treatment contractors. Provides training specific to person-centered treatment planning, suicide prevention, and/or the American Society of Addiction Medicine (ASAM) placement criteria. Provides technical assistance with the utilization of the County’s electronic medical record system. Enhances knowledge and expertise by attending workshops, conferences, seminars, and other skill-building opportunities. Acts as liaison between program staff and the Division.

KNOWLEDGE, SKILLS, AND ABILITIES (KSA)

Knowledge of: Mental health and substance abuse treatment, prevention, theory, and practice Individual, family, and community dynamics regarding mental health and substance abuse Utilization management techniques, including case rate purchasing of services Records retention policies and procedures, and federal confidentiality regulations (HIPAA) Substance use prevention and treatment continuum in Salt Lake County Health care benefit plans, managed care organizations, and marketing to private health organizations Theories, practices, and training techniques in learning, research, and program evaluation Community organization and public/media relations Fiscal management, regulatory funding requirements, and grant writing Medicaid rules and regulations Current State Office of Substance Use and Mental Health (OSUMH) preferred practice standards Skills and Abilities to: Perform clinical and program monitoring/auditing of treatment agencies Organize, manage, demonstrate leadership techniques, and provide mentoring Develop and provide program and training material Communicate effectively both verbally and in writing Present effectively to groups Relate with individuals and groups from diverse ethnic, social, and economic backgrounds Perform effectively in stressful situations Act independently Additional Information

WORKING CONDITIONS AND PHYSICAL REQUIREMENTS

Position requires some traveling between the County and the local area provider(s)' offices. #J-18808-Ljbffr UNAVAILABLE