Clinical Services QA Advisor in Chesapeake, VA at Beacon Health Options

Date Posted: 9/15/2018

Job Snapshot

Job Description

ABOUT THE POSITION

We are currently seeking a dynamic Clinical Services Quality Assurance Advisor to join our team.  The Clinical Services Quality Assurance Advisor will partner with the Military OneSource Management team to evaluate clinical and quality performance by monitoring calls and correspondence, daily.

Position Responsibilities:

  • Monitors, evaluates and documents member or provider calls for designated staff to ensure staff responses meet VO’s clinical and quality audit standards, and provides managers, supervisors and clinical care managers with call coaching quality data.  Partners with the management team to ensure frequent performance and developmental feedback are provided to the Military OneSource staff.
  • Compiles/reports monitoring evaluation data and presents call coaching sessions.  Provides Military OneSource staff with an action plan for process improvement, and if needed collaborates with the management team in the corrective action process by gathering documentation regarding non-compliance in meeting required standards.  Contributes to performance improvement plans and participates in discussions, up to and including termination.
  • Ensure processes are in place to support compliance with all state and federal laws (HIPAA), regulatory requirements, accrediting agencies (NCQA and URAC) as well as ValueOptions’ clinical criteria and policies and procedures.
  • Compiles and presents summary level call coaching and efficiency data which becomes part of each Military OneSource staff’s performance review. Assures integrity and confidentiality of call monitoring documentation and evaluates/develops monitoring tools to support efficiency and effectiveness in the call monitoring process.
  • Audits the timeliness and accuracy of any contractual follow up inquiries made by Military OneSource staff.  Measures the ability of staff to successfully meet all client performance expectations and presents final assessments/employment recommendations to management.
  • Identifies improvements or training opportunities and develops/presents quality improvement training materials to improve overall service quality.  Identifies trends in inquiry monitoring and applies corrective actions as necessary to meet business needs. Ensures follow through with Military OneSource staff.
  • Develops ideas for performance improvement, service delivery, and cross-functional initiatives that contribute to department success.

Position Requirements:

Education: Master’s degree in Social Work or one of the other core mental health disciplines. 

Licensure : Current, valid and unrestricted Independent Clinical License.

Relevant Work Experience:    A minimum of five years post graduate clinical/administrative experience, some of which has been in a supervisory capacity.  Requires solid knowledge base and working knowledge of mental health systems with clear understanding of psychiatric clinical case management.

This contract requires U.S. Citizenship .

TO APPLY

Click below on “Apply for this Position” to create a profile and apply for the position

ValueOptions Federal Services, Inc., a Beacon Health Options company, 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

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