Quality Assurance Specialist, Mental Health

Wayfinder Family Services • Los Angeles, CA

4d • $25 - $27 • Onsite

About The Position

At Wayfinder Family Services, we understand the unique challenges facing some of our state’s most vulnerable children, youth and adults. Those with disabilities, those without a home of their own, those who have been abused and many, many more. We answer the call for them. We believe in the amazing potential in, and for, each and every one of them. And, together, we find a way to turn that potential into reality. Program and Role Summary Wayfinder’s Mental Health offers therapy to children, youth, adults and families in the program. Our mental health care in the community is focused on preventative services to build resilient individuals and families. The primary focus of the Clinical Quality Assurance Specialist is to oversee various areas of billing and documentation for compliance to contractual obligations and agency policy and procedures, to provide training and feedback to service delivery staff on areas of needed correction/improvement, and to work collaboratively with supervisors and management staff to ensure the accuracy of client documentation and records. Promotes a healthy organizational culture based on trust, respect, empowerment and accountability Ensures sensitivity to the service population’s cultural and socioeconomic characteristics. Responsible for the review and content compliance of any and all documentation submitted to the Mental Health client record, including (but not limited to), intake documents, Assessments, Client Treatment Plans, Progress Notes, Change of Diagnoses, Outcome Measures, medication support/psychiatric documents, and correspondence. Ensures the “Clinical Loop” of Medical Necessity is documented in the Mental Health client record in accordance with Wayfinder Family Services and Los Angeles Department of Mental Health (DMH) Policy and Procedures. Works collaboratively with Directors, Clinical Program Managers and/or staff tasked with clinical supervision to ensure that initial and ongoing Medical Necessity for all client services is demonstrated at the time of assessment, in the development of the treatment plan(s), at required cycle periods, and in every Progress Note for billed services across all modes of treatment. Conducts reconciliation, document-specific reviews, and full chart reviews, and provides feedback on needed corrections, trends, areas of needed training, and missing information to service delivery staff, all respective supervisors, and the Director of Mental Health Services. Maintains a tracking system of vital client information, documentation due dates, cycle dates, and pending documentation, and uses this tracking information to provide reminders to service delivery staff, reports to supervisors, and to monitor overall employee and program compliance. Provides new-hire training on the required content of DMH documentation, billing procedures, direct service delivery practices, client care, effective time-management, agency Policy and Procedures, and quality assurance systems of training and support.

Requirements

• Bachelor’s degree in Psychology, Social Work, Human Services, or a relevant field preferred.
• One (1) year of experience working within a contracted and/or directly-operated Los Angeles County Department of Mental Health program that serves high-risk children, adolescents, adults and/or families OR One (1) year of experience with reviewing/overseeing Los Angeles County Department of Mental Health billing, documentation, client records, quality assurance, policy and procedures, and training protocols required.
• Proficient in the use of Microsoft Word, Excel and Outlook programs required.

Nice To Haves

• Trained in Intensive Care Coordination (ICC), Intensive Home-Based Services (IHBS), and the Core Practice Model preferred.
• Trained in Evidenced-Based Practices (e.g. Seeking Safety, Managing Adaptive Practice – MAP, Aggression Replacement Training – ART, Trauma-Focused Cognitive Behavioral Therapy – TF-CBT, etc.) preferred.

Responsibilities

• Responsible for the review and content compliance of any and all documentation submitted to the Mental Health client record, including (but not limited to), intake documents, Assessments, Client Treatment Plans, Progress Notes, Change of Diagnoses, Outcome Measures, medication support/psychiatric documents, and correspondence.
• Ensures the “Clinical Loop” of Medical Necessity is documented in the Mental Health client record in accordance with Wayfinder Family Services and Los Angeles Department of Mental Health (DMH) Policy and Procedures.
• Works collaboratively with Directors, Clinical Program Managers and/or staff tasked with clinical supervision to ensure that initial and ongoing Medical Necessity for all client services is demonstrated at the time of assessment, in the development of the treatment plan(s), at required cycle periods, and in every Progress Note for billed services across all modes of treatment.
• Conducts reconciliation, document-specific reviews, and full chart reviews, and provides feedback on needed corrections, trends, areas of needed training, and missing information to service delivery staff, all respective supervisors, and the Director of Mental Health Services.
• Maintains a tracking system of vital client information, documentation due dates, cycle dates, and pending documentation, and uses this tracking information to provide reminders to service delivery staff, reports to supervisors, and to monitor overall employee and program compliance.
• Provides new-hire training on the required content of DMH documentation, billing procedures, direct service delivery practices, client care, effective time-management, agency Policy and Procedures, and quality assurance systems of training and support.

Benefits

• Wayfinder is committed to providing our employees with a benefits program that is both comprehensive and competitive which includes:
• Paid Time Off: Generous Paid Time Off (PTO) policy, 11 paid holidays, plus five winter holidays
• Medical, dental, vision, life, and long-term disability insurance
• 401(k) retirement plan with employer match up to 4%
• Employee referral program: Encourage your colleagues to join us
• Education tuition assistance program: Invest in your career development
• Public Service Loan Forgiveness (PSLF) eligible
• Flexible spending account (FSA) plans
• Eligibility and other benefits are outlined in plan documents

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level