Clinical Quality Assurance Coordinator

Overview

Clinical Quality Assurance Coordinator role at Children's Institute. The position uses independent judgement to perform complex program reviews and analyses that support contract compliance and program performance, adheres to chart and program documentation requirements, program reporting and preparation for agency audits. Ensures compliance with legal, ethical, contractual and agency requirements and standards.

Responsibilities

• Analyzes and evaluates charts, summarizes findings, and shares them with appropriate supervisors, managers, and leadership.
• Acts as primary liaison with the Department of Mental Health's (DMH) Standards and Records Department and internal managers for documentation issues with other funders.
• Identifies clinical staff in need of chart documentation training; develops training material and conducts training for managers, supervisors, and staff.
• Prepares for audits utilizing the Electronic Health Record System (EHRS) and the claiming system; collaborates with VP's, Director of Compliance, Clinical Program Managers, Supervisors, HIM, Custodian of Records, and leadership for audit purposes.
• Analyzes and evaluates documentation for accuracy of clinical content and procedure billing codes for DMH Contracts.
• Develops and implements tracking forms and systems to audit chart documentation to federal and county regulations; identifies and recommends methods to streamline procedures and improve efficiency.
• Collaborates with VP's, clinical managers, and supervisors to prepare for audits by DMH, Department of Child and Family Services, and other funders.
• Leads audits; maintains working expert knowledge of program standards and agency policies as developed by the agency, licensing bodies, and other governing entities.
• Develops personal and professional knowledge through educational activities and benchmarking best practices.

Qualifications

50%); ability to work with minimal supervision; ability to handle confidential information; maintains patient privacy and PHI security; participates in performance quality improvement activities; cultural sensitivity; excellent verbal and written communication; punctual and dependable attendance; free from alcohol and drug abuse; aligns with CII's mission.

Compensation

$73,601.00 USD - $85,469.00 USD. In accordance with California law, the expected pay range is included in this posting; actual compensation will be determined based on factors permitted by law. New hires start at the lower end to maintain internal equity with opportunities for growth.

Benefits

Contingencies

Note : This description summarizes the essential responsibilities and qualifications for the role. It does not imply contractual obligations.

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