Quality Assurance Specialist

Quality Assurance Specialist

The Quality Assurance (QA) Specialist is responsible for vetting and ensuring the accuracy, completeness, and compliance of the client charts within the program. This role focuses on vetting authorization charts, monitoring documentation timelines, and ensuring adherence to payer, regulatory, and organizational standards. The QA Specialist collaborates closely with Clinical Managers to ensure accuracy of charts, communicate upcoming client deadlines regarding treatment plans, assessments, authorization expiration dates and other related client information.

Will interact and communicate with clinical managers, clinical director, and program manager as it relates to required services.

Primary Job Responsibilities:

• Review and vet client charts for completeness, accuracy, and program/regulatory compliance.
• Confirm Consumer Choice Forms and required consents are completed and up-to-date.
• Monitor for expired or expiring treatment plans and authorizations.
• Track and follow up on Diagnostic Assessment (DA) updates
• Monitor DLA-20 completion and required updates
• Monitor CAFAS updates for child/adolescent clients (when applicable)
• Proactively communicate deficiencies, expiring documentation, and corrective actions to Clinical Managers, Care Coordinators, and administrative staff.
• Maintain and update tracking system.
• Collaborate and Communicate with Community Support Workers.
• Support internal audits and prepare documentation for external reviews
• Participate in scheduled meetings, including staff meetings and clinical meetings
• Participate in trainings to maintain and enhance job skills
• Participate in internal quality improvement initiatives.
• Perform other responsibilities within reason as needed.

Job Skills:

• Must have excellent verbal and written communication skills, active listening skills and exceptional customer service skills to evaluate clients, assess their care needs and guide through the admissions process
• Proficient with data entry and other technical computer skills requiring information to be entered into digital systems, accessing digital forms, and creating electronic patient files
• Must have excellent time management skills to schedule appointments for patients and manage multiple patients at once
• Commitment to ethical practice and adherence to all professional and legal confidentiality guidelines

Qualifications:

• High School Diploma Required, Bachelor's degree preferred
• 2+ years experience in behavioral health
• Experience using Electronic Health Records (EHR) systems.
• Experience using Microsoft Suite (Excel, Word, Powerpoint)

Competencies:

• Do the Right Thing Doing what's right starts with integrity. It means being honest about your actions, your intentions, and how you treat peopleespecially when no one's watching.
• Own It Everyone has a part. If you've been trusted with something, it's because it's yours to manage. When we all take care of our piece, everything runs like it should.
• Serve First Follows policies and procedures; Completes administrative tasks correctly and on time; Supports organization's goals and values; Benefits organization through outside activities; Supports affirmative action and respects diversity.
• Choose Solutions You always have a choice. Our strength is in choosing what moves us forward. Be someone who solves, and choose what helps, not what hurts.
• Lead with Respect You can't lead others if you don't respect yourself first. Respect shows up in how we speak, how we act, and how we care for people. Leadership starts inside.
• Commit to the Goal The plan might shift. The process might change. People might come and go. But the goal stays the goal. Get thereand make sure we're getting there together.