Clinical Services Quality Auditor (RN, LCSW, LPC, LMFT)

Employer
Beacon Health Options
Location
Arlington, VA
Posted
Oct 13, 2017
Closes
Oct 16, 2017
Function
Audit and Tax, Nurse
Industry
Healthcare, Other
Hours
Full Time
ABOUT THE POSITION We are currently seeking a dynamic Clinical Services Quality Auditor to join our team. The Clinical Services Quality Auditor will ensure the delivery of excellent service to internal and external customers for the Military OneSource (MOS) Contract through exceptional interpersonal and communication skills, effective leadership, planning, process management and information analysis, to promote a customer focused environment. Position Responsibilities: Monitors, evaluates and documents member or provider calls for designated staff to ensure staff responses meet VO's clinical and quality audit standards, and provides managers, supervisors and clinical care managers with call coaching quality data. Partners with the management team to ensure frequent performance and developmental feedback are provided to the Military OneSource Staff. Compiles/reports monitoring evaluation data and presents call coaching sessions. Provides Military OneSource Staff with an action plan for process improvement, and if needed collaborates with the management team in the corrective action process by gathering documentation regarding non-compliance in meeting required standards. Contributes to performance improvement plans and participates in discussions, up to and including termination. Ensure processes are in place to support compliance with all state and federal laws (HIPAA), regulatory requirements, accrediting agencies (NCQA and URAC) as well as ValueOptions Federal Services Inc. (R) clinical criteria and policies and procedures. Compiles/reports monitoring evaluation data and presents call coaching sessions. Provides Military OneSource Staff with an action plan for process improvement, and if needed collaborates with the management team in the corrective action process by gathering documentation regarding non-compliance in meeting required standards. Contributes to performance improvement plans and participates in discussions, up to and including termination. Audits the timeliness and accuracy of any contractual follow up inquiries made by Military OneSource staff. Measures the ability of staff to successfully meet all client performance expectations and presents final assessments/employment recommendations to management. Identifies improvements or training opportunities and develops/presents quality improvement training materials to improve overall service quality. Identifies trends in inquiry monitoring and applies corrective actions as necessary to meet business needs. Ensures follow through with Military OneSource Staff. Develops ideas for performance improvement, service delivery, and cross-functional initiatives that contribute to department success. Collaborates with the management team on new client implementation activities, including development/presentation of training materials, to ensure all home service center and client performance expectations are met. Position Requirements: Education : Registered Nurse with Bachelor's Degree and/or Master's degree in Social Work or one of the other core mental health disciplines . Licensure : Current, valid, and unrestricted Clinical License . Relevant Work Experience: A minimum of five year post graduate clinical/administrative experience, some of which has been in a supervisory capacity. Require solid knowledge base and working knowledge of mental health systems with clear understanding of psychiatric clinical case management. This contract requires US citizenship. TO APPLY Click below on "Apply for this Position" to create a profile and apply for the position ValueOptions Federal Services, Inc, Beacon Health Options company, is proud to be an Equal Opportunity and Affirmative Action Employer as well as a Drug Free and Tobacco Free Work Environment. EOE/AA/M/F/Veterans/Disabled $FDL #CB PM16