The Center for Alternative Sentencing and Employment Services (CASES) · 1 day ago
Quality Auditor
New York, NY
Part-time
Remote
Entry Level
$65K/yr - $65K/yr
1+ years exp
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Responsibilities
Conduct internal chart review and audits to confirm client records meet standards of care, licensing, medical necessity, State and MCO Medicaid regulations.
Complete timely utilization review (UR) of client documentation for medical necessity admission and continuing stay, and discharge reasons; develop recommendations shared with managers and monitor how UR decisions are implemented by the treatment team.
Coordinate and support the incident reporting and review program according to NYS Part 524 regulations, promoting effective staff onboarding and training, engaging and helpful incident review meetings, timely minutes, and follow-up procedures and practices. Ensure incidents are documented, investigated, and appropriately reviewed.
Support risk management practices for clients with high vulnerability for poor outcomes related to suicide, violence, and medical problems working collaboratively with treatment program managers on quality of care and evidence-based treatment services.
Conduct continuous quality improvement (CQI) initiatives with treatment program managers to improve program performance and client outcomes.
Monitor and ensure treatment programs comply with client privacy and release of confidential protected healthcare information, including HIPAA and 42 CFR Part 2 Confidentiality for Substance Use Disorder Treatment.
Conduct real-time review and approval of documentation that will be shared with criminal legal system stakeholders about client status and progress in treatment.
Develop and deliver training programs and staff coaching on policies and procedures, documentation, incident reporting, and standards of care to meet the needs of new hires and each treatment program, in compliance with local, state, and federal regulations.
Demonstrate a commitment to diversity, equity, and inclusion through continuous development and modeling inclusive behaviors.
Qualification
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Required
Experience working with regulatory agencies, including OMH, DOHMH, and OMIG.
Knowledgeable about relevant laws and regulations, such as HIPAA and 42 CFR Part 2.
Must have experience using billing systems.
Maintain a high degree of accuracy along with attention to detail.
Prioritize assignments and meet stringent deadlines.
Ability to provide strengths-based constructive feedback, deal with sensitive issues, and maintain confidentiality, all with a focus on improved quality.
Value diversity, equity, and belonging and contribute to an inclusive work environment.
Excellent communications verbal, written, presentation, and interpersonal skills.
Proficient with MS Office (Word, Excel, PowerPoint, Outlook, Teams, and SharePoint).
Preferred
LMSW, LMHC is preferred with at least 1 year of quality improvement and compliance experience with NYS licensed treatment programs.
License not required at time of hire, but candidates must be willing to obtain licensure within 6 months of employment. Clinical supervision hours may be provided to support candidates in obtaining licensure.
Benefits
Medical
Dental
Vision
Vacation and Paid Time Off – starting at 25 days-off annually, plus an additional summer self-care day
12 Paid Holidays per year
Retirement 403b Competitive matching up to 6%
Employee Referral Program
Company
The Center for Alternative Sentencing and Employment Services (CASES)
CASES is one of New York City's leading providers of bail and jail alternatives, mental health treatment, and education and employment programs for youth and adults who are involved in the justice system.
501-1000 employees
Funding
Current Stage
Late StageLeadership Team
Jonathan McLean
Chief Executive Officer
Ann-Marie Louison
Chief Impact Officer
Recent News
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