Cenikor is a non-profit organization and one of the largest substance abuse treatment centers in the nation. We are currently seeking a Full-Time Quality Auditor Behavioral Health for a remote position in Houston, TX.

JOB SUMMARY:

Quality Auditor Behavioral Health provides quality assurance auditing related to compliance with quality guidelines as set by federal and state regulatory bodies and 3rd party payors.

SCHEDULE: Monday - Friday 8a - 5p

ESSENTIAL FUNCTIONS:

• Complete clinical documentation audits by reviewing service delivery documentation via all clinical and medical staff.
• Demonstrate ability to work in collaboration with the clinical intake assessment, utilization review, and compliance departments to identify trends in clinical service delivery related to regulatory compliance.
• Identify overall trends and training opportunities related to clinical quality audits.
• Track identifiable negative /risk trends and identify improvement plans for intervention and measurement of outcomes
• Complete editing and updating of quality tool in conjunction with the Clinical Effectiveness Director.
• Review assigned payer sites for policy changes, manual updates, and provider bulletins regarding the service delivery requirements, and be able to communicate process or payor related changes throughout the foundation.
• Maintain responsibility for knowing and following TAC 448, ASAM, TDI, CARF, and other clinical regulatory criteria regulations.
• Maintain current research regarding all relevant regulations related to 3rd party payors and regulatory boards.
• Participate in all appropriate or required committee meetings.
• Assist with the development of training materials, presentations and applicable guides for distribution to designated departments and staff as assigned by Clinical Quality Effectiveness Director.
• Lead and contribute to interdepartmental quality audits.
• Uphold the core principles of Cenikor’s culture and create a positive working environment for all team members.
• Maintain strict confidentiality on all client and foundation matters and refer questionable issues to supervisor.
• Perform additional duties as assigned and consistent with the exempt functions as defined in this job description.

QUALIFICATIONS FOR THE POSITION:

Skills, Knowledge, and Abilities:

• Possess strong interpersonal skills as well as the ability to collaborate effectively with Clinical Effectiveness Director and related departments within the foundation
• Maintain knowledge of state and other applicable regulatory requirements.
• Knowledge in computer, particularly word processing, database management- data gathering and analysis and desktop publishing
• Strong knowledge of federal, state, and 3rd party regulations
• Experience in an environment that heavily utilizes writing, organizational, and interpersonal skills
• Ability to work cooperatively with a diverse group of individuals, including staff, clients,
• Ability to serve both internal and external customers and agencies.
• Possess superior organizational skills
• Possess excellent written and verbal communication skills, and excellent interpersonal skills
• Ability to handle multiple responsibilities in a highly professional manner
• Must be self-directed and self-motivated
• Ability to consistently uphold the Core Principles of Cenikor’s Culture:
  • Demonstrate mission of service to our clients
  • Positive, respectful communication with both staff and clients
  • Demonstrate self-motivation and perseverance to achieve goals
  • Role model appropriate, professional behaviors including appropriate client boundaries
  • Work effectively as part of a team, helping to set up others for success

Education:

• Master’s Degree in Social Science or Public Health related field required with at least 2 years of post-graduation experience preferred, but consideration will be given to candidates with bachelor’s degree and comparable auditing experience.

Experience:

• Minimum of one-year experience in chart auditing/review, in behavioral health or substance use setting required
• Two years’ experience working in primary mental health, substance abuse, or co-occurring treatment facility, preferably in an acute inpatient or residential setting required
• Strong knowledge and experience working within the following regulating boards and guidelines required:
  • Commission on Accreditation of Rehabilitation Facilities (CARF)
  • Joint Commission
  • Texas Administrative Code
  • Commercial and State Insurance Guidelines
  • American Society of Addictive Medicine (ASAM)
  • Diagnostic and Statistical Manual (DSM-V)

IMPORTANT NOTES:

• DRUG FREE WORKPLACE
• EQUAL OPPORTUNITY EMPLOYER

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