Business Analyst - Psychiatry Administration

Business Analyst - Psychiatry Administration

The Business Analyst is responsible for reviewing medical records to ensure accuracy, completeness, and compliance with regulatory and organizational standards. This role focuses on evaluating treatment plans and 90-day summaries to confirm appropriate documentation, quality of care, and adherence with the applicable guidelines of the South Carolina Department of Health and Human Services (SCDHHS) Community Mental Health Rehab Contract.

Charleston, South Carolina

Administrative, Operations, Program, & Project Management

Business Operations

Full Time

MUSC Physicians (MUSCP)

Job Description Summary

The Business Analyst is responsible for reviewing medical records to ensure accuracy, completeness, and compliance with regulatory and organizational standards. This role focuses on evaluating treatment plans and 90-day summaries to confirm appropriate documentation, quality of care, and adherence with the applicable guidelines of the South Carolina Department of Health and Human Services (SCDHHS) Community Mental Health Rehab Contract.

Entity

University Medical Associates (UMA) Only Employees and Financials

Worker Type

Employee

Worker Sub-Type

Unclassified

Cost Center

CC001040 COM PSYCH Admin Operations CC

Pay Rate Type

Salary

Pay Grade

Health-26

Scheduled Weekly Hours

40

Work Shift

Monday - Friday, 8:30 am - 5:00 pm

Required Education or Experience:

Bachelors Degree or equivalent Work Experience: 5 years for support or 0-2 years for professional

Job Duties:

20% - Evaluate treatment plans to ensure they are properly completed, documented, and signed by an MD or APP. Ensure these are completed yearly for every Medicaid patient.

20% - Analyze all Medicaid patient charts to ensure 90-day summaries to verify timely completion, accuracy, and alignment with patient care goals. These must be completed within 90 days of admission to an outpatient psychiatric clinic and for individuals that have not been seen in 6 months.

10% - Review medical records for completeness, accuracy, and compliance with state (SCDHHS) and organizational regulations.

10% - Complete daily audits following all MUSCP Compliance procedures and report monthly findings to Director of Practice, Department Administrator, Chairman or other leaders as directed on a monthly basis.

10% - Act as the Data Manager to track and report audit findings, trends, and areas of risk to leadership and the individual providers. Develop the methodology for audits and reports to present findings in a clear concise manner. Responsible for follow up audits to validate resolution of documentation issues and completion of corrective action plans.

10% - Assist in the development and deployment of educational/training materials and campaigns; communicates proactively extensively throughout the system to provide education on compliance matters related to the South Carolina Department of Health and Human Services (SCDHHS) Community Mental Health Rehab Contract.

5% - Identify documentation gaps, inconsistencies, or potential compliance risks.

5% - Provide feedback and recommendations to clinical staff to improve documentation quality.

5% - Responsible for entering all education sessions into designated system per departmental instructions.

5% - Performs other duties as assigned.

Preferred Education & Experience:

Experience educating physicians in group or individual sessions. Demonstrates solid technical knowledge, understanding of business concepts, regulatory rules, and auditing procedures. Experience researching questions and providing documentation to support decisions regarding the Medicaid Rehab Contract. Excellent communication and interpersonal skills. Knowledge of Microsoft Office Applications including Word, Excel, and PowerPoint. Experience with and aptitude for using medical billing software.

Must be able to act independently in the furtherance of compliance objectives following MUSCP Compliance Department and organizational established policies and procedures. Must be able to identify and respond to escalated problems or questions in a timely fashion.

Physical Requirements

Continuous requirements are to perform job functions while standing, walking and sitting. Ability to bend at the waist, kneel, climb stairs, reach in all directions, fully use both hands and legs, possess good finger dexterity, perform repetitive motions with hands/wrists/elbows and shoulders, reach in all directions. Maintain 20/40 vision corrected, see and recognize objects close at hand and at a distance, work in a latex safe environment and work indoors. Frequently lift and/or carry objects weighing 20 lbs (+/-) unassisted. Lift from 36" to overhead 15 lbs. Infrequently work in dusty areas and confined/cramped spaces.

The Medical University of South Carolina is an Equal Opportunity Employer. MUSC does not discriminate on the basis of race, color, religion or belief, age, sex, national origin, gender identity, sexual orientation, disability, protected veteran status, family or parental status, or any other status protected by state laws and/or federal regulations. All qualified applicants are encouraged to apply and will receive consideration for employment based upon applicable qualifications, merit and business need.

Medical University of South Carolina participates in the federal E-Verify program to confirm the identity and employment authorization of all newly hired employees.