QA QI Analyst – DMC – ODS

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🔥 0 minutes ago

🏄 California – Remote

🏄 California – Remote

💵 $95k - $115k / 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 Insurance

🤝 Non-profit

🏛️ Government

Healthcare Insurance • Non-profit • Government

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

• Support the implementation of DMC-ODS requirements across access, network, utilization management, reporting, member information, and quality improvement functions • Maintain utilization management tracking tools, logs, and documentation files • Coordinate credentialing/recredentialing packets and provider directory updates • Collect, organize, and analyze quality, utilization, access, grievance, provider performance, and compliance data to identify trends, risks, and follow-up needs • Coordinate meetings, agendas, materials, notes, follow-up items, and documentation for quality management, provider monitoring

🎯 Requirements

• Bachelor’s degree in Public Health, Behavioral Health, Social Work, Healthcare Administration, Public Administration, Psychology, Sociology, or related field, required • Minimum of three (3) years of experience in behavioral health, substance use disorder services, quality management, utilization management, compliance, provider monitoring, program administration, data/reporting, or a closely related field, required • Experience with DMC-ODS, Medi-Cal behavioral health managed care, substance use disorder treatment systems, or county behavioral health plan operations, strongly preferred • Experience working within or directly with a County Behavioral Health Plan, particularly supporting DMC-ODS quality management, reporting, utilization management, provider monitoring, or compliance functions, strongly preferred • Strong understanding of DMC-ODS, Medi-Cal behavioral health managed care, county behavioral health systems, and provider compliance requirements • Knowledge of quality management, utilization management, provider monitoring, grievances/appeals, network adequacy, timely access, and state reporting workflows

🏖️ Benefits

• Access to various applications • Maintain confidentiality and integrity of systems