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Quality Auditor

Remote: 
Full Remote
Contract: 
Full time
Salary: 
65 - 65K yearly
Experience: 
Junior (1-2 years)
Work from: 
New York (USA), United States

Offer summary

Qualifications:

LMSW, LMHC preferred, 1 year of experience in quality improvement, Knowledge of HIPAA and related regulations, Proficient with MS Office.

Key responsabilities:

  • Conduct internal audits and reviews
  • Coordinate incident reporting programs
  • Ensure compliance with privacy regulations
  • Deliver training on policies and procedures
The Center for Alternative Sentencing and Employment Services (CASES) logo
The Center for Alternative Sentencing and Employment Services (CASES)
See more The Center for Alternative Sentencing and Employment Services (CASES) offers

Job description

Job Title: Quality Auditor


Job Summary:


CASES is seeking a Quality Auditor to join our team and support the delivery of high-quality mental health treatment programs. The successful candidate will have experience working with regulatory agencies, including OMH, DOHMH, and OMIG, and be knowledgeable about relevant laws and regulations, such as HIPAA and 42 CFR Part 2.


Shift Hours: The Quality Auditor position is full-time Monday through Friday from 9:00 am to 5:00 pm or part-time with a minimum of 20 hours per week. 

Location Address: 151 Lawrence Street Brooklyn, NY 11201. 

Workplace Flexibility: 100% remote.

Salary: The salary for the Quality Auditor role is $65,000 per year, with part-time schedules compensation pro-rated. 


What you will be doing: 

  • Conduct internal chart review and audits to confirm client records meet standards of care, licensing, medical necessity, State and MCO Medicaid regulations.
  • Complete timely utilization review (UR) of client documentation for medical necessity admission and continuing stay, and discharge reasons; develop recommendations shared with managers and monitor how UR decisions are implemented by the treatment team.
  • Coordinate and support the incident reporting and review program according to NYS Part 524 regulations, promoting effective staff onboarding and training, engaging and helpful incident review meetings, timely minutes, and follow-up procedures and practices. Ensure incidents are documented, investigated, and appropriately reviewed.
  • Support risk management practices for clients with high vulnerability for poor outcomes related to suicide, violence, and medical problems working collaboratively with treatment program managers on quality of care and evidence-based treatment services. 
  • Conduct continuous quality improvement (CQI) initiatives with treatment program managers to improve program performance and client outcomes.
  • Monitor and ensure treatment programs comply with client privacy and release of confidential protected healthcare information, including HIPAA and 42 CFR Part 2 Confidentiality for Substance Use Disorder Treatment.
  • Conduct real-time review and approval of documentation that will be shared with criminal legal system stakeholders about client status and progress in treatment.
  • Develop and deliver training programs and staff coaching on policies and procedures, documentation, incident reporting, and standards of care to meet the needs of new hires and each treatment program, in compliance with local, state, and federal regulations.
  • Demonstrate a commitment to diversity, equity, and inclusion through continuous development and modeling inclusive behaviors.

What we are looking for: 

  • LMSW, LMHC is preferred with at least 1 year of quality improvement and compliance experience with NYS licensed treatment programs.
  • License not required at time of hire, but candidates must be willing to obtain licensure within 6 months of employment. Clinical supervision hours may be provided to support candidates in obtaining licensure.
  • Must have experience using billing systems.
  • Maintain a high degree of accuracy along with attention to detail.
  • Prioritize assignments and meet stringent deadlines.
  • Ability to provide strengths-based constructive feedback, deal with sensitive issues, and maintain confidentiality, all with a focus on improved quality.
  • Value diversity, equity, and belonging and contribute to an inclusive work environment.
  • Excellent communications verbal, written, presentation, and interpersonal skills.
  • Proficient with MS Office (Word, Excel, PowerPoint, Outlook, Teams, and SharePoint).


Employee Benefits:

CASES cares about employee wellbeing, and we offer a comprehensive benefits package to support you and your family, including:  

  • Medical 
  • Dental 
  • Vision 
  • Vacation and Paid Time Off – starting at 25 days-off annually, plus an additional summer self-care day
  • 12 Paid Holidays per year
  • Retirement 403b Competitive matching up to 6%
  • Employee Referral Program
  • Visit www.cases.org/careers/ to learn more about benefits offered by the CASES

Although we would love to learn about the skills of every candidate, only selected candidates that are selected will receive a response. We encourage you to apply for any position(s) you feel you are qualified for.  


CASES is proud to be an Equal Opportunity Employer. Employment with CASES is based solely on qualifications and competence for a particular position without regard to race, color, ethnic or national origin, age, religion, creed, gender, sexual orientation, disability, or marital, military, or citizenship status. We also actively recruit individuals with prior involvement in the criminal legal system.


Monday - Friday 9am - 5pm.
35 hours weekly excluding breaks.

Required profile

Experience

Level of experience: Junior (1-2 years)
Spoken language(s):
English
Check out the description to know which languages are mandatory.

Hard Skills

Compliance RequirementsQuality ImprovementRegulatory ComplianceRisk ManagementLine ChartUtilization Management

Other Skills

  • Time Management
  • Communication
  • Social Skills
Are you interested?

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