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Primary Purpose of Position: This position is responsible for the assessment of services delivered to consumers to ensure that services are consistent with funding requirements, best practices, provider contracts and federal/state rules and regulations. This position monitors provider agencies and independent practitioners within the provider network receiving reimbursement for service provision under the 1915(b)/(c) waivers and with State funding. Working with a team of reviewers/auditors, the Quality Management Monitoring Specialist will interpret monitoring results to identify trends/patterns that impact service/system quality, and then to implement interventions aimed at addressing these trends/patterns with the outcome of service delivery to consumers at the highest degree of quality.
Role and Responsibilities:
Knowledge, Skills and Abilities:
Education and Experience Required:
Bachelor’s degree and 3 years of utilization review, auditing, monitoring, credentialing, or quality management experience in MH/SU/I-DD or 3 years with any combination thereof. Must have ability to travel as needed to perform job duties. Basic National Certified Investigator & Inspector Training (NCIT) within twelve (12) months of hire.
Education and Experience Preferred:
Master’s Degree with Clinical licensure preferred. Must be a current and unrestricted clinical license with the appropriate professional board of licensure in the state of North Carolina.
Licensure/Certification Required: N/A
Full Time
Ambulatory Healthcare Services
$82k-108k (estimate)
06/02/2024
08/01/2024
partnersbhm.org
GASTONIA, NC
200 - 500
2012
RHETT MELTON
$10M - $50M
Ambulatory Healthcare Services
Partners Health Management is the local manager of mental health, substance use disorder, and intellectual and developmental disabilities treatment available through Medicaid, state, and county funding. We contract with care providers to ensure that treatment options are available for eligible residents of Burke, Catawba, Cleveland, Gaston, Iredell, Lincoln, Rutherford, Surry, and Yadkin counties. Our Crisis Line is available all day, every day at 1-888-235-HOPE (4673). Learn more about us at www.PartnersBHM.org.