Quality Assurance Specialist

The pay range for this role is $26.38 - $30.33 per hour.

About Didi Hirsch

Didi Hirsch Mental Health Services has been a national leader in whole-person mental health, crisis care, and substance use services since 1942 and is home to the nation's first Suicide Prevention Center. We are a nonprofit organization providing care to about 270,000 people annually across our programs. Didi Hirsch has deep roots in community-based mental health and a commitment to providing culturally responsive services that are just and equitable. More than 1,000 dedicated employees and volunteers make Didi Hirsch's work possible.

Summary

As Quality Assurance Specialist, you will assist the QI Manager with managing quality assurance tasks that include conducting program/staff audits, ensuring accuracy of data collection/entry of staff into required systems, tracking program compliance with appropriate enforcement bodies, as well as assisting with necessary agency certifications and licensing.

Primary Duties

• Maintains and monitors the accuracy and integrity of data entry for practitioner databases (i.e. NAPPA, NPES, PRM, etc.) on a monthly/quarterly basis.
• Designs and maintains tracking reports of new hire data entry in the electronic health record.
• Assists with Medi-Cal and DHCS certification and re-certification processes.
• Facilitates formal documentation reviews and completion of associated reports to monitor for compliance with contract/regulatory standards.
• Assists with review and resolution of problematic claims and other billing issues.
• Collaborates with other agency systems and programs.
• Assists with development of key performance targets necessary for reporting requirements.
• Attends Los Angeles County provider meetings (as needed).
• Assist with design and implementation of staff training on QA trends, program updates, etc.
• Evaluates and tracks discharge pending statuses.
• Identifies, tracks and creates plan to address QA items needing corrective action.

Secondary Duties

• Other program reviews to ensure compliance with regulatory requirements (State, Federal, County).
• Other quality assurance activities as needed.

Position Requirements

• Minimum requirement is an Associate's Degree; Bachelor's Degree preferred.
• Quality Assurance experience preferred.
• Meticulous attention to details to ensure accuracy and completeness of agency records.
• Strong organizational skills and ability to juggle multiple deadlines.
• Very clear oral and written communication skills.
• Strong working knowledge of managed health care plans preferred.
• Demonstrates strong customer-service oriented interpersonal skills.
• Flexibility and ability to adapt to changing priorities and needs.
• A commitment to team objectives and Didi Hirsch philosophies.

Our Vision

A future where everyone has equitable access to care and is empowered to achieve optimal mental health and well-being.

Our Mission

Didi Hirsch provides compassionate mental health, substance use, and suicide prevention services to individuals and families, especially in communities where discrimination and injustice limit access.

CORE VALUES

Excellence: We are constantly innovating, learning from the communities we serve, and applying the latest research to advance best practices. We uphold the highest ethical standards to ensure we are providing compassionate and excellent care.
Diversity & Inclusion: We value diversity of background, experience, and ideas, committing to a workforce representative of the communities we serve. We celebrate differences and prioritize creating a sense of belonging.
Equity: We are dedicated to maintaining equitable practices in our healthcare delivery and workplace culture, and we work to dismantle disparities and discrimination within both systems of care and society.
Well Being: We are devoted to the well-being of our staff, volunteers, and communities, and believe healthy teams lead to healthy clients.
Advocacy: We advocate across all levels of government and use our voice to reduce barriers to care, including stigma, systemic racism, and parity across payers, with the goal of access to high quality, integrated healthcare for all.
Community Engagement: We build partnerships in the community and across sectors to create a more inclusive and responsive mental health ecosystem and enhance greater accessibility to care and support.

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