Business Analyst - Psychiatry Administration

Overview 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 to the applicable guidelines of the South Carolina Department of Health and Human Services (SCDHHS) Community Mental Health Rehab Contract. Responsibilities 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. Analyze all Medicaid patient charts to ensure 90-day summaries are completed within 90 days of admission to an outpatient psychiatric clinic and for individuals that have not been seen in 6 months. Review medical records for completeness, accuracy, and compliance with state (SCDHHS) and organizational regulations. Complete daily audits following all MUSCP Compliance procedures and report findings monthly to leadership. Act as the Data Manager to track and report audit findings, trends, and areas of risk to leadership; develop methodology for audits and follow-up to validate resolution of documentation issues. Assist in the development and deployment of educational/training materials and campaigns to provide education on compliance matters related to SCDHHS Community Mental Health Rehab Contract. Identify documentation gaps, inconsistencies, or potential compliance risks. Provide feedback and recommendations to clinical staff to improve documentation quality. Enter all education sessions into the designated system per departmental instructions. Perform other duties as assigned. Qualifications Minimum: Bachelor’s Degree or equivalent work experience; 5 years for support roles or 0-2 years for professional roles. Ability to act independently in furtherance of compliance objectives following MUSCP Compliance Department and organizational policies and procedures. Ability to identify and respond to escalated problems or questions in a timely fashion. Preferred Education & Experience Experience educating physicians in group or individual sessions. 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. Physical Requirements Must perform job functions while standing, walking, and sitting. Must bend at the waist, kneel, climb stairs, reach in all directions, 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, work in a latex-safe environment and indoors. Frequently lift and/or carry objects weighing 20 lbs, lift from 36" to overhead 15 lbs. Infrequently work in dusty areas and confined/cramped spaces. EEO Statement 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. #J-18808-Ljbffr