Clinical Quality Analyst

About the Role

We’re a team of passionate, forward-thinking professionals eager to take on the challenge of the mental health crisis and play a formative role in providing life-saving solutions. If you’re inspired by our mission and energized by the opportunity to increase access to mental healthcare and impact millions of lives in a profound way, apply today.

The Clinical Quality Analyst is responsible for ensuring quality medical and clinical processes are conducted in accordance with company, industry, accreditation, state, and federal guidelines. This person will perform and manage quality assurance and clinical audits related to medical and clinical functions for quality, accuracy, and consistency to ensure an efficient process. This person will collaborate with clinical teams to resolve identified findings and recognize trends or broader areas of risk. The Clinical Quality Analyst will also review incident reports, support serious incident analysis, participate in survey preparation, and assist with corrective action plans and new state or program launches. This person will be familiar with company policy and be able to develop and constantly evaluate workflow procedures to ensure documentation compliance. This position assists with the development and maintenance of system policies and procedures, knowledge base, process improvements, and system improvements. 

Responsibilities

• Audit assigned medical and clinical records daily and meet established productivity expectations
• Apply audit criteria consistently and accurately
• Complete monitoring reports that summarize audit results, findings, and trends
• Provide education and feedback based on audit findings and identified opportunities for improvement
• Lead and/or participate in the implementation of quality improvement processes
• Provide direct support to clinical teams implementing quality improvement initiatives
• Assist in developing cross-company documentation procedures that support clinical compliance
• Collaborate with administration and other departments to develop effective interdepartmental procedures
• Notify the Quality and Safety Manager of matters related to the integrity of the medical record
• Maintain a high level of confidentiality related to audit reviews and findings
• Submit medical records as requested and within required timeframes
• Provide accurate reporting on compliance and quality initiatives
• Provide accurate reports to the Director of Quality, Safety, and Compliance Operations upon request
• Participate in state, Medicaid, payer, and accreditation survey-preparedness initiatives
• Assist with incident reporting, review, tracking, and investigation procedures, including serious incident analysis
• Support corrective action plans and complete required follow-up within established timeframes
• Support Quality and Safety readiness activities for new state or program launches
• Participate in special projects
• Perform other duties related to the position as assigned

Requirements

• 2+ years of experience in healthcare auditing
• Bachelors or master’s degree in behavioral health or similar field preferred
• Healthcare or behavioral health operations experience preferred
• Strong knowledge of state and federal statutes regarding patient confidentiality laws
• Knowledge of ASAM criteria
• Knowledge of mental health recovery model and LOC guidelines
• Knowledge of behavioral health guidelines or assessments, treatment plans, and LOC
• Knowledge of The Joint Commission Behavioral Health Standards
• Ability to work with sensitive and/or confidential information
• Proficient in Microsoft Office, especially Word & Excel
• Basic understanding of applicable laws, regulations, industry standards, and related compliance issues, particularly regarding The Joint Commission and State accreditation
• Exhibits a comprehensive understanding of healthcare regulatory and compliance (HIPAA)
• Ability to function independently with minimal supervision
• Ability to collaborate effectively with clinical and cross-functional teams
• Please note that members of this team who live within 45 minutes of a Charlie Health office are expected to adhere to a hybrid work schedule

Benefits

Charlie Health is pleased to offer comprehensive benefits to all full-time, exempt employees. Read more about our benefits here.

The total target base compensation for this role will be between $57,000 - $75,000 per year at the commencement of employment. Please note, pay will be determined on an individualized basis and will be impacted by location, experience, expertise, internal pay equity, and other relevant business considerations. Further, cash compensation is only part of the total compensation package, which, depending on the position, may include other Charlie Health-sponsored benefits.  

Note: We are not currently considering applicants in AK, CA, CO, CT, MA, ME, MN, NJ, NY, OR, WA and Washington D.C. for this position.#LI-REMOTE