Quality Compliance Specialist

Gladstone Psych & Wellness•Baltimore, MD

21h•$24 - $26•Hybrid

About The Position

The Quality Compliance Specialist supports clinical quality, documentation accuracy, and regulatory compliance within a psychiatry and behavioral health practice. This role focuses on monitoring patient engagement, auditing clinical documentation, supporting prior authorization processes, and ensuring compliance with payer, regulatory, and internal standards. The specialist works closely with psychiatric providers, clinical leadership, and administrative teams to support high-quality, compliant patient care.

Requirements

A minimum of an associates degree
Experience in behavioral health, psychiatry, healthcare administration, compliance, or medical records
Strong attention to detail and ability to manage sensitive clinical information
Proficiency with electronic health records (EHR) and standard office software
Strong analytical and organizational skills
Clear and professional written and verbal communication
Ability to collaborate effectively with psychiatric providers and clinical teams
Discretion and sound judgment when handling confidential behavioral health information
Experience in completing Prior Authorizations for medications
Strong skills in general computerized tasks, including excel with data manipulation, word, google, etc.

Nice To Haves

Associate’s or Bachelor’s degree in Healthcare Administration, Psychology, Health Information Management, or related field
Familiarity with behavioral health documentation standards, audits, and prior authorization processes
Knowledge of HIPAA and behavioral health confidentiality regulations

Responsibilities

Connect with patients requiring completion of new or updated intake and clinical paperwork
Connect with patients not seen within the past three months for scheduling
Prepare and manage patient discharge letters in accordance with behavioral health policies and continuity-of-care requirements
Coordinate with providers and administrative staff to resolve missing or incomplete documentation
Support the Prior Authorizations team and process Prior Authorizations as needed
Conduct regular provider note compliance checks
Audit patient charts for completeness
Assist in developing and maintaining audit tools, compliance workflows, and documentation
Support quality improvement initiatives related to patient access, retention, and documentation compliance
Maintain strict confidentiality and compliance with HIPAA and organizational policies