Quality Assurance Utilization for Program Planning - Chicago, United States - Healthcare Alternative Systems, Inc (H.A.S)

Healthcare Alternative Systems, Inc (H.A.S)
Healthcare Alternative Systems, Inc (H.A.S)
Verified Company
Chicago, United States

1 month ago

Mark Lane

Posted by:

Mark Lane

beBee recruiter
Description

Quality Assurance Utilization for Program Planning
4534 S Western Ave

Chicago, IL 60609

Full Time


Healthcare Alternative Systems, Inc. (H.A.S.) is a 501 (c) 3 non-profit organization providing behavioral health services to Chicago and the surrounding communities. We offer a continuum of programs addressing substance abuse, mental health, adolescent issues, family relationships, and more. Every year, H.A.S. serves over six thousand individuals.


Benefits:


  • Competitive hourly salary
  • Health insurance (PPO, HMO)
  • Paid time off
  • Dental insurance
  • Vision insurance
  • Flexible spending account (FSA) / Health savings account (HSA)
  • Life insurance
  • CEU eligible onsite trainings
  • Supervision
- $200 Professional Development


Essential Functions:

The Quality Assurance Utilization Review Specialist will be responsible for the review of clinical documentation throughout H.A.S.

ensuring that clinical documentation is in line with compliance regulations following CARF, SUPR, IDHS and while promoting H.A.S.' mission statement.


Utilization Review Specialist Responsibilities:


  • Act as a liaison between the leadership team and H.A.S professional clinical staff.
  • Act in coordination with the leadership team to improve the quality of services provided within the organization.
  • Ensure that clinical documentation is in line with identified KPI's as outlined in the Program Plans cohesively align with CARF, SUPR, DMH, etc, rules and standards.
  • Conduct Utilization Reviews monthly to ensure appropriate allocation of services, placement and treatment decisions, and adequate clinical documentation.
  • Confirms that discharge criteria and continuing/aftercare plans are in place and are consistent; Action Planning and Management of the process.
  • Develop reports of audited results through a dashboard of data while incorporating a narrative form from the various sources of data collected.
  • Facilitate the process to assess program performance and make recommendations on measurable goals and objectives for improvements in program standards.
  • Assist in creating Corrective Actions Plans (CAPs) monthly. This will be to identify the areas of deficiencies, corrective actions/steps needed, responsible person(s) for implementing the corrective actions, and due dates/timeframes based on the findings from the Utilization Reviews.
  • Complete a HIPAA Confidentiality Checklist at each site monthly to reinforce the rules and regulations, as well as to identify areas of deficiency that require improvement.
  • Keep accurate record of all contact with external organizations and persons who have legitimate interest and legal access to information of the care of participants.
  • Collaborate with each program monthly via Team Meeting to ensure that information is fluid and discussions surrounding CAP, supervision and required documentation is occurring.
  • Collaborate with PM and PD to ensure understanding of needed documentation and to review details in the Corrective Action Plan.
  • Able to work with others in a professional climate, able to engage with the Executive Team as well as Board of Directors as needed to share Annual reports.
  • Meet with the Clinical Training Director for Clinical supervision as scheduled.

Utilization Review Specialist Qualifications:


  • Flexible to adapt to schedules and workload to the needs and demands of the QA Department.
  • Knowledge of State and Federal Behavioral Health Regulations.
  • Knowledge of DHS regulations and service rules; as well as CARF standards or other accreditation bodies is preferred.
  • Possess both excellent written and verbal communication skills.
  • Ability to maintain a professional manner across a variety of different programs.
  • Possession of a valid Illinois Driver's License and willingness to use personal vehicle during the course of employment.
  • The position is onsite only.

Education and Experience Requirements:


  • LCPC, LCSW, LPC, and/or CADC is required.
  • Master's degree and/or Bachelor's degree from a regionally accredited educational institution which has U.S. Department of Education approval is required.
  • Knowledge of ASAM criteria, DSM 5, and ICD10 is preferred.
  • Knowledge of Substance Use Disorders programs, Mental Health programs, and/or other Behavioral Health programs is preferred.
**EOE
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