QA QI Clinician – QA & Compliance

Job not on LinkedIn

🕒 August 7

🏄 California – Remote

🏄 California – Remote

💵 $120k - $140k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🔧 QA Engineer (Quality Assurance)

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California Mental Health Services Authority

WebsiteLinkedInAll Job Openings

51 - 200 employees

Founded 2009

🏥 Healthcare

💼 Consulting

⚕️ Healthcare Insurance

Healthcare • Consulting • Healthcare Insurance

California Mental Health Services Authority (CalMHSA) is an independent administrative and fiscal public entity representing California counties. It focuses on transforming mental health care by developing electronic health records (EHR) and promoting interoperability among various health IT systems. CalMHSA supports counties in improving mental health services through initiatives like early psychosis intervention, workforce development, suicide prevention hotlines, and research on equity and community impact. The organization works closely with county behavioral health departments to enhance support for mental health initiatives, especially in underserved communities.

📋 Description

• Lead and support quality assurance, compliance, utilization management, quality improvement, and other clinical and operational initiatives for California county behavioral health plans. • Conduct clinical documentation reviews, quality audits, and program audits for compliance with federal, state, contractual, and organizational requirements. • Monitor quality and performance measures, establish KPIs, analyze data and trends, and recommend improvements. • Develop, implement, monitor, and evaluate data-driven quality improvement initiatives. • Develop and maintain clinical resource guides, documentation manuals, policies, procedures, implementation tools, and operational resources. • Interpret behavioral health laws, regulations, contractual requirements, and guidance and translate them into operational recommendations and implementation strategies. • Develop and deliver behavioral health training programs, educational materials, and presentations. • Provide technical assistance and implementation support to county behavioral health plans. • Manage multiple projects and competing priorities while meeting timelines and maintaining high-quality deliverables. • Maintain current knowledge of behavioral health laws, regulations, contractual requirements, and industry best practices. • Collaborate with county behavioral health plans, state agencies, vendors, providers, and multidisciplinary teams. • Identify process improvements, enhance operational efficiency, and implement innovative solutions. • Handle sensitive and confidential behavioral health information in accordance with HIPAA, 42 CFR Part 2, privacy laws, and CalMHSA security policies.

🎯 Requirements

• Current, active, and unrestricted California clinical license required: LCSW, LMFT, LPCC, Psychologist (PhD/PsyD), or equivalent California behavioral health clinical license. • Minimum 3 years of experience performing quality assurance, quality improvement, utilization management, compliance, or related quality oversight activities within California’s public behavioral health system, including county BHPs. • Demonstrated knowledge of DHCS regulatory requirements, county BHP operations, and clinical documentation standards. • Experience supporting behavioral health QA, QI, utilization management, compliance, and/or policy implementation initiatives. • Strong written and verbal communication skills. • Strong analytical and critical thinking skills. • Ability to interpret and apply federal and state behavioral health laws, regulations, policies, and guidance. • Ability to manage multiple priorities, organize complex workstreams, meet deadlines, and maintain accuracy. • Ability to collaborate with multidisciplinary teams, county partners, vendors, and stakeholders. • Proficiency with Microsoft Office Suite and ability to learn new technology platforms. • Intermediate knowledge of Excel, Word, PowerPoint, Adobe, and Outlook. • Ability to work with little or no supervision, conduct research, and ask appropriate probing questions. • Ability to handle confidential information in compliance with HIPAA Privacy and Security Rules, 42 CFR Part 2, state and federal privacy laws, and CalMHSA security policies. • Ability to work regular business hours of 8 a.m. to 5 p.m., Monday–Friday, with schedule varying according to business needs.