Senior Quality Assurance Analyst
Recruiting.com
Clinical Quality Assurance Specialist
BetterHelp
full-time
Posted on:
Location Type: Remote
Location: Remote • 🇺🇸 United States
Visit company websiteSalary
💰 $75,000 - $98,000 per year
Job Level
JuniorMid-Level
About the role
- Conduct thorough clinical chart audits to ensure compliance with BetterHelp's clinical standards of practice and evidence-based treatment protocols
- Review patient documentation for accuracy, completeness, and adherence to regulatory requirements and insurance coverage criteria
- Evaluate treatment planning, progress notes, and clinical decision-making against established clinical guidelines and best practices
- Identify patterns of clinical excellence and areas for improvement in documentation and care delivery
- Maintain detailed audit findings and recommendations in compliance with quality assurance protocols
- Support the day-to-day operations of the quality assurance team, including audit scheduling, tracking, and reporting
- Participate in preparing necessary documentation for insurance audits. Download the requested patient records and policies & procedures.
- Collaborate with clinical teams to address audit findings and implement corrective action plans
- Assist in developing and refining clinical audit tools, checklists, and evaluation criteria
- Contribute to quality assurance training materials and educational resources for clinical staff
- Participate in quality improvement initiatives based on audit findings and clinical trends
- Ensure all clinical chart reviews meet insurance payer requirements and regulatory standards
- Monitor compliance with state licensing requirements, professional practice standards, and accreditation criteria
- Support preparation for external audits and regulatory reviews by maintaining comprehensive documentation
- Stay current with evolving insurance requirements and clinical practice standards that impact quality assurance processes
- Collaborate with compliance teams to address any regulatory or contractual requirements identified through audit processes
Requirements
- Master's or Doctoral degree in psychology, clinical social work, counseling, psychiatry, or closely related mental health field
- Current, active clinical license in good standing (LCSW, LPC, LMFT, PsyD, PhD, MD, or equivalent)
- Minimum 2+ years of clinical practice experience with direct patient care and clinical documentation
- Strong understanding of evidence-based mental health treatment practices and clinical documentation standards
- Exceptional attention to detail with ability to identify discrepancies and areas for improvement in clinical records
- Experience with electronic health records (EHR) systems and clinical documentation platforms
- Excellent written and verbal communication skills with ability to provide constructive feedback to clinical colleagues
- Experience with clinical auditing, quality assurance, or utilization review in healthcare settings (preferred)
- Knowledge of insurance requirements, medical necessity criteria, and value-based care standards (preferred)
- Background in virtual care delivery or digital health platforms (preferred)
- Familiarity with regulatory requirements for mental health services and clinical documentation (preferred)
- Experience working with diverse clinical teams and providing clinical supervision or consultation (preferred)
Benefits
- Remote work with regular in-person bonding experiences sponsored by the company
- Competitive compensation
- Holistic perks program (including free therapy, employee wellness, and more)
- Excellent health, dental, and vision coverage
- 401k benefits with employer matching contribution
- The chance to build something that changes lives – and that people love
- Any piece of hardware or software that will make you happy and productive
- An awesome community of co-workers
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
clinical chart auditsclinical documentationtreatment planningquality assuranceclinical auditingutilization reviewevidence-based treatment practicesinsurance requirementsmedical necessity criteriavalue-based care standards
Soft skills
attention to detailwritten communicationverbal communicationconstructive feedbackcollaborationproblem-solvingorganizational skillstraining developmentcritical thinkingadaptability
Certifications
LCSWLPCLMFTPsyDPhDMD
