Clinical Quality Analyst

Summary

Charlie Health provides personalized, virtual behavioral healthcare treatment for mental health conditions, substance use disorders, and eating disorders. The Clinical Quality Analyst ensures medical and clinical processes comply with company, industry, accreditation, state, and federal guidelines by conducting audits, analyzing findings, supporting quality improvement initiatives, reviewing incidents, and assisting with compliance readiness and corrective action plans.

Responsibilities

• Audit assigned medical and clinical records daily and meet established productivity expectations
• Apply audit criteria consistently and accurately
• Complete monitoring reports that summarize audit results, findings, and trends
• Provide education and feedback based on audit findings and identified opportunities for improvement
• Lead and/or participate in the implementation of quality improvement processes
• Provide direct support to clinical teams implementing quality improvement initiatives
• Assist in developing cross-company documentation procedures that support clinical compliance
• Collaborate with administration and other departments to develop effective interdepartmental procedures
• Notify the Quality and Safety Manager of matters related to the integrity of the medical record
• Maintain a high level of confidentiality related to audit reviews and findings
• Submit medical records as requested and within required timeframes
• Provide accurate reporting on compliance and quality initiatives
• Provide accurate reports to the Director of Quality, Safety, and Compliance Operations upon request
• Participate in state, Medicaid, payer, and accreditation survey-preparedness initiatives
• Assist with incident reporting, review, tracking, and investigation procedures, including serious incident analysis
• Support corrective action plans and complete required follow-up within established timeframes
• Support Quality and Safety readiness activities for new state or program launches
• Participate in special projects
• Perform other duties related to the position as assigned

Skills

• 2+ years of experience in healthcare auditing
• Strong knowledge of state and federal statutes regarding patient confidentiality laws
• Knowledge of ASAM criteria
• Knowledge of mental health recovery model and LOC guidelines
• Knowledge of behavioral health guidelines or assessments, treatment plans, and LOC
• Knowledge of The Joint Commission Behavioral Health Standards
• Ability to work with sensitive and/or confidential information
• Proficient in Microsoft Office, especially Word & Excel
• Basic understanding of applicable laws, regulations, industry standards, and related compliance issues, particularly regarding The Joint Commission and State accreditation
• Exhibits a comprehensive understanding of healthcare regulatory and compliance (HIPAA)
• Ability to function independently with minimal supervision
• Ability to collaborate effectively with clinical and cross-functional teams
• Please note that members of this team who live within 45 minutes of a Charlie Health office are expected to adhere to a hybrid work schedule
• Bachelors or master's degree in behavioral health or similar field preferred
• Healthcare or behavioral health operations experience preferred

Qualifications

Must Haves

• 2+ years of experience in healthcare auditing
• Strong knowledge of state and federal statutes regarding patient confidentiality laws
• Knowledge of ASAM criteria
• Knowledge of mental health recovery model and LOC guidelines
• Knowledge of behavioral health guidelines or assessments, treatment plans, and LOC
• Knowledge of The Joint Commission Behavioral Health Standards
• Ability to work with sensitive and/or confidential information
• Proficient in Microsoft Office, especially Word & Excel
• Basic understanding of applicable laws, regulations, industry standards, and related compliance issues, particularly regarding The Joint Commission and State accreditation
• Exhibits a comprehensive understanding of healthcare regulatory and compliance (HIPAA)
• Ability to function independently with minimal supervision
• Ability to collaborate effectively with clinical and cross-functional teams
• Please note that members of this team who live within 45 minutes of a Charlie Health office are expected to adhere to a hybrid work schedule

Nice to Haves

• Bachelors or master's degree in behavioral health or similar field preferred
• Healthcare or behavioral health operations experience preferred

Benefits

• Comprehensive benefits for all full-time, exempt employees.
• Members of this team who live within 45 minutes of a Charlie Health office are expected to adhere to a hybrid work schedule.