Behavioral Health Quality Assurance Specialist
at Avita Community Partners

Date Posted: 12/12/2019

Job Description


Job Duties:

Under general to limited supervision, the Quality Assurance Manager works with other departments, as needed, to evaluate the medical necessity, appropriateness and effectiveness of paraprofessional behavioral health services provided for the purpose of maintaining quality care through judicious use of resources.

•Coordinates and performs service eligibility authorization review, quality assurance and billing compliance audits, service access, and continued stay reauthorization reviews.
•Acts as liaison between Avita service providers and third-party payers, managed care organizations, and external review organizations as needed in the performance of utilization and quality assurance management..
•Provides reports for internal and external use for performance evaluation and improvement.
•Interprets National and State standards, rules, regulations, and best practice guidelines relevant to Avita programs, policies, standards, and guidelines on corporate compliance, utilization management, and quality assurance.


Requirements
Minimum Qualifications:
Must have a bachelor’s degree in a social science.

Preferred Qualifications:
•Experience in Behavioral Health Care utilization management/utilization review and or quality assurance, and experience using computer applications such as word processing, electronic health records, spreadsheets, and other database management software.

Avita Community Partners is an Equal Opportunity Employer and does not discriminate in its service practices or employment practices with regard to race color, religion, disability, gender, sexual orientation, age, or national origin.

The selected candidate will be subject to a FBI Criminal History Record Check. Applicants reserve the right to challenge the contents of a FBI Criminal History Record Check.

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Job Snapshot

About Us

Avita Community Partners is a resource for individuals and families in northeast Georgia experiencing the disabling effects of mental illness, developmental disabilities, and addictive diseases. Our goal is to assist in the development of safe, stable, meaningful lives for all.

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