This position will be responsible for activities involving quality management and compliance with applicable regulatory requirements (AHCCCS, Banner Health Plan, Arizona Complete Care Contract ). Essential functions include:Work in a multidisciplinary environment requiring a broad range of experience, analytical, communications and interpersonal skills. Responsible for implementing and monitoring program providers, applicable regulatory and statutory requirements, and defining quality requirements for development of audit tools based on ACC Contract. Coordinate and educate quality guidelines and performance measures with providers. Assist in the root cause analysis and any associated corrective and preventive action(s) in response to provider audits. Conduct audits, including risk assessments and tracks and trend results of medical record reviews creating audit finding reports and approval of proper corrective and preventive actions, while providing technical assistance and training to providers and staff in methodologies and tools of continuous quality improvement.Close out audit findings while ensuring timely resolution of investigations and associated corrective actions.
Uses best practices and knowledge of internal or external business challenges to suggest improvements to services, processes or products.
Solves complex problems. Takes a new perspective using existing solutions.
Interprets customer needs, assesses requirements and identifies solutions to non-standard requests. Interacts primarily with department and cross-department peers, supervisor, customers, peers managers, patients and physicians.
Makes decisions within approved operating plans and objectives and within functional policies and precedents. Determines how and when to achieve results.
Bachelors degree or equivalent working knowledge in the field of Behavioral Health related fields.
Two to four years of relevant experience in quality management, process improvement, project leadership, organization/time management skills, data collection/analysis, client relations, program development, streamline processes, project evaluation, budget management, training and development.
Az Board of Behavioral Health Licensing and/or CPHQ
Additional related education and/or experience preferred.
You want to change the health care industry – one life at a time. You belong here. You’re excited to be part of the dramatic changes happening in the health care field. In fact, you thrive on change. But you also understand that excellent, compassionate patient care is the true measure of the success of these changes. You belong at Banner Health. Our award-winning, comprehensive health system includes 23 hospitals in seven western states, primary care health centers, research centers, labs, a network of physician practices and much more. Throughout our system, skilled, compassionate professionals use the latest technology to change the way care is provided. If you’re looking to be a key contributor to a forward-looking organization, you’ll experience a wide variety of professional advantages: •Our vision for changing the future of health care gives you the opportunity to leverage your abilities to achieve something historic. •Our expansive system offers you an unmatched variety of clinical settings – from large urban trauma center to small rural hospital, ambulatory to home health. Our system also includes hospitals specializing in cancer, heart health and pediatrics. •Our many loc...ations also translate into a broad selection of exciting and rewarding lifestyle options – from the big city to the wide-open spaces. •Our commitment to healthcare innovation means you always have the latest technologies at your fingertips to help you provide the finest care possible. •The size, success and growth of our system provide you with the stability and options to pursue your desired career path. •Our competitive compensation and comprehensive benefits offer you options to complement your unique needs.