Clinical Quality Assurance Specialist

🕒 Abril 27

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BetterHelp

SiteLinkedInTodas as Vagas

1 - 10 funcionários

Fundada em 2013

👥 B2C

⚕️ Seguro de Saúde

🧘 Bem-estar

B2C • Healthcare Insurance • Wellness

BetterHelp é o maior serviço de terapia online do mundo, oferecendo uma plataforma onde indivíduos podem se conectar com terapeutas licenciados por meio de sessões de texto, chat, áudio ou vídeo. O serviço permite que os usuários encontrem facilmente um terapeuta que atenda às suas necessidades e preferências específicas, tornando o apoio à saúde mental acessível de qualquer lugar e a qualquer momento. Com uma rede de mais de 30. 000 profissionais licenciados, a BetterHelp busca melhorar o bem-estar mental atendendo a uma variedade de questões, como depressão, ansiedade, relacionamentos e traumas, garantindo o mesmo nível de profissionalismo da terapia tradicional em consultório.

Descrição

• Conduct thorough clinical chart audits to ensure compliance with BetterHelp's clinical standards of practice and evidence-based treatment protocols • Review patient documentation for accuracy, completeness, and adherence to regulatory requirements and insurance coverage criteria • Evaluate treatment planning, progress notes, and clinical decision-making against established clinical guidelines and best practices • Identify patterns of clinical excellence and areas for improvement in documentation and care delivery • Maintain detailed audit findings and recommendations in compliance with quality assurance protocols • Support the day-to-day operations of the quality assurance team, including audit scheduling, tracking, and reporting • Participate in preparing necessary documentation for insurance audits. Download the requested patient records and policies & procedures. • Collaborate with clinical teams to address audit findings and implement corrective action plans • Assist in developing and refining clinical audit tools, checklists, and evaluation criteria • Contribute to quality assurance training materials and educational resources for clinical staff • Participate in quality improvement initiatives based on audit findings and clinical trends • Ensure all clinical chart reviews meet insurance payer requirements and regulatory standards • Monitor compliance with state licensing requirements, professional practice standards, and accreditation criteria • Support preparation for external audits and regulatory reviews by maintaining comprehensive documentation • Stay current with evolving insurance requirements and clinical practice standards that impact quality assurance processes • Collaborate with compliance teams to address any regulatory or contractual requirements identified through audit processes

🎯 Requisitos

• Master's or Doctoral degree in psychology, clinical social work, counseling, psychiatry, or closely related mental health field • Current, active clinical license in good standing (LCSW, LPC, LMFT, PsyD, PhD, MD, or equivalent) • Minimum 2+ years of clinical practice experience with direct patient care and clinical documentation • Strong understanding of evidence-based mental health treatment practices and clinical documentation standards • Exceptional attention to detail with ability to identify discrepancies and areas for improvement in clinical records • Experience with electronic health records (EHR) systems and clinical documentation platforms • Excellent written and verbal communication skills with ability to provide constructive feedback to clinical colleagues. • Experience with clinical auditing, quality assurance, or utilization review in healthcare settings • Knowledge of insurance requirements, medical necessity criteria, and value-based care standards • Background in virtual care delivery or digital health platforms • Familiarity with regulatory requirements for mental health services and clinical documentation • Experience working with diverse clinical teams and providing clinical supervision or consultation

🏖️ Benefícios

• Remote work with regular in-person bonding experiences sponsored by the company • Competitive compensation • Holistic perks program (including free therapy, employee wellness, and more) • Excellent health, dental, and vision coverage • 401k benefits with employer matching contribution • The chance to build something that changes lives – and that people love • Any piece of hardware or software that will make you happy and productive • An awesome community of co-workers