Business Professional Job In Rocky Hill, Connecticut
Healthcare Quality Management Specialist II
This job was posted 7 days ago. Be one of the first applicants.
CT: Rocky Hill (500 Enterprise Drive, Suite 4D)
Quality Mgmt / Performance Improvement
Responsible for reviewing provider treatment records as part of the CT Behavioral Health Partnership (CT BHP) Record Review Program for the purpose of ensuring quality of care.
ABOUT THE POSITION
We are currently seeking a dynamic Quality Management Specialist II to join our team at our office in Rocky Hill. The Quality Management Specialist II will be responsible for reviewing provider treatment records as part of the CT Behavioral Health Partnership (CT BHP) Record Review Program for the purpose of ensuring quality of care, verifying documentation to support information received during medical necessity reviews, and confirming conformance with treatment record documentation standards.
- Plays a lead role in maintaining the Quality of Care Committee including maintenance of files associated with the committee and meeting minutes.
- Review provider records submitted to CT BHP based on potential quality of care concern. Elevate for medical director review as appropriate.
- Maintains a working knowledge of CT BHP documentation standards and requirements.
- Conduct internal documentation audits of CT BHP clinical staff documentation.
- Assists in the identification and notification of providers who will participate in the treatment record review process. Arranges all necessary details to begin on site review and communicates with providers as necessary.
: Master's Degree Required
Licensure: Independent clinical license
Relevant Work Experience: 5 years of professional experience in the mental health /substance abuse field. General knowledge of managed care, quality management, and utilization management principles preferred. Good writing, analytical, and verbal presentation skills.
Knowledge, Skills & Abilities:
- General knowledge of managed care, quality management and utilization management principles preferred.
- Basic computer skills required
- Good writing, analytical and verbal presentation skills required.
- Knowledge of Microsoft Office Products
Beacon Health Options is proud to be an Equal Opportunity and Affirmative Action Employer as well as a Drug Free and Tobacco Free Work Environment. EOE/AA/M/F/Veterans/Disabled
At Beacon Health Options, our candidate's data privacy is a top priority. Our recruiting team conducts all communications using official company email (@BeaconHealthOptions.com). Only candidates who have applied for an open position through our Careers page (careers.beaconhealthoptions.com) will be engaged in our interview process. Beacon conducts all interviews in person or over the phone. At no time during the recruiting process will any Beacon recruiter request any financial or personally identifiable information from you.
AAP Reporting Location:
CT - Rocky Hill
ID (Req #):