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Behavioral Health Quality Assurance Specialist I - Days

Location: WellSpan Medical Group, York, PA

Schedule: Full Time

Sign-On Bonus Eligible

Remote/Hybrid

Regular

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Full-time, Days

General Summary

Conducts chart audits, uses data for healthcare quality measures to review for trends and gaps related to quality documentation to ensure compliance with regulatory and payor agencies. Elevates and communicates gaps and opportunities through established channels.

Duties and Responsibilities

Remote Work Capable

Essential Functions:

• Supports the organization's commitment to comply with all federal, state, and local standards, with an emphasis on Mental Health and Substance Abuse regulatory agency requirements.

• Demonstrates knowledge of regulatory and payor guidelines as they pertain to documentation requirements, quality review requirements, and policies and procedures.

• Performs monthly audits of Behavioral Health medical records to ensure compliance with regulatory and payor agencies.

• Enters and tracks data collected from monthly audits into an electronic format for reporting purposes and identification of compliance related trends.

• Identifies compliance documentation opportunities and provides consultation and education to clinicians, leadership and others.

• Maintains appropriate records, reports, and files as required for the department.

• Covers responsibilities for peers in their absence.

Common Expectations:

• Maintains established policies and procedures, objectives, quality assessment, safety, environmental and infection control standards.

• Participates in educational programs and staff meetings required for the department.

• Provides outstanding service to all customers; fosters teamwork; and practices fiscal responsibility through improvement and innovation.

• Attends meetings as required.

Required for All Jobs:

• Performs other related duties as identified.

• WellSpan Health has adopted and implemented a compliance program to support WellSpan's values and standards for professionalism, integrity, and ethics. Expected to support and meet the values and standards of the organization and the performance expectations of the job, the department, and the compliance program.

• WellSpan Health has adopted and implemented a privacy program to safeguard the patient information and the business and operational information of the organization. Expected to support and meet the values and standards of the organization to safeguard patient and business/operational information.

The above statements are intended to describe the general nature and level of work being performed. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified.

Physical Demands:

• Standing - Occasionally

• Walking - Occasionally

• Sitting - Frequently

• Reaching - Rarely

• Talking - Frequently

• Hearing - Frequently

• Repetitive Motions - Occasionally

• Eye/Hand/Foot Coordination - Occasionally

Working Environment:

• Occupational Hazards - Occasionally

Qualifications

Minimum Education:

• High School Diploma or GED Required

• Associates Degree Preferred or

• Bachelors Degree Preferred

Work Experience:

• 2 years Working in Behavioral Health. Required or

• 2 years Working in a Quality Assurance role. Required

Knowledge, Skills, and Abilities:

• Excellent communication and interpersonal skills.

• Demonstrated basic to intermediate to advanced proficiency with Microsoft Office Suite/Excel.

• Detail Oriented.

• Critical thinking skills.

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You’re unique and you belong here.

At WellSpan Health, we are committed to treating all applicants fairly and equitably, regardless of their job classification. If you require assistance or accommodation due to a disability, please reach out to us via email atemployment@wellspan.org. We will evaluate requests for accommodation on a case-by-case basis. Please note that we will only respond to inquiries related to reasonable accommodation from this email address. Rest assured, all requests for assistance or accommodation are handled confidentially, allowing applicants to share their needs openly and honestly with us.

WellSpan Health is an Equal Opportunity Employer. It is the policy and intention of the System to maintain consistent and equal treatment toward applicants and employees of all job classifications without regard to age, sex, race, color, religion, sexual orientation, gender identity, transgender status, national origin, ancestry, veteran status, disability, or any other legally protected characteristic.