Quality assurance specialist

Job Details:

Job Location: North Sacramento Office - Sacramento, CA

Position Type: Full Time

Education Level: 4 Year Degree

Salary Range: $20.19 - $25.25 Hourly

Travel Percentage: Up to 25%

Job Shift: Day/AM

Job Category: Nonprofit - Social Services

At Wayfinder Family Services, we understand the unique challenges facing some of our state’s most vulnerable children, youth and adults. Those with disabilities, those without a home of their own, those who have been abused and many, many more. We answer the call for them. We believe in the amazing potential in, and for, each and every one of them. And, together, we find a way to turn that potential into reality.

Position and Role Summary

Wayfinder’s ATLAS program connects Sacramento County children, youth, and families to community outreach, early intervention, outpatient mental health, and Therapeutic Behavioral Services that improve access to care, strengthen families, and support long-term stability. The primary focus on the Quality Assurance Specialist is to oversee documentation, billing, and evidence-based practice fidelity for ATLAS, Wayfinder's integrated children's specialty mental health services program under contract with Sacramento County Behavioral Health Services, reviewing records for compliance with contractual obligations and agency policy, providing training and feedback to service delivery staff on areas needing correction or improvement, and working collaboratively with supervisors and management to ensure the accuracy of client documentation and records.

Primary Responsibilities:

• Responsible for the review and content compliance of all documentation submitted to the client record, including intake documents, assessments, client treatment plans, progress notes, changes of diagnosis, outcome measures, medication support and psychiatric documents, and correspondence.
• Conducts reconciliation, document-specific reviews, and full chart reviews, and provides feedback on needed corrections, trends, areas needing training, and missing information to service delivery staff, their supervisors, and the Program Director.
• Maintains a tracking system of vital client information, documentation due dates, cycle dates, and pending documentation, and uses that tracking to provide reminders to staff, reports to supervisors, and monitoring of overall employee and program compliance.
• Verifies that each activity is classified to the correct funding stream and that documentation supports the classification claimed across Medi-Cal SMHS under EPSDT, BHSA Early Intervention, MH-MAA, CalAIM BH-CONNECT Community Health Worker services, and Medi-Cal Peer Support Services, and escalates classification questions to the responsible Clinical Program Manager or, for Outreach and Engagement and Early Intervention activities, the Early Intervention and Outreach and Engagement Program Manager.
• Tracks evidence-based practice fidelity at the program level, including PCIT session-level fidelity, DPICS-IV coded observation, session integrity checks, and treatment completion metrics.
• Coordinates with the Quality, Risk, and Performance Improvement division on quarterly evidence-based practice performance review and quarterly disparity review of access and outcome data across the priority ZIP communities.
• Supports housing-related documentation compliance, including Housing Support Plans maintained in the health record and HMIS enrollment for clients meeting homelessness criteria, and supports assembly of the quarterly housing stabilization report to the County.
• Provides new-hire training on required documentation content, billing procedures, direct service delivery practices, client care, effective time management, agency policies and procedures, and quality assurance systems.
• Provides ongoing training to ATLAS staff on documentation content, billing procedures, service delivery practices, time management, agency policies and procedures, and quality assurance systems, and updates training content as County and DHCS guidance changes.
• Performs other duties as may become necessary or as directed.

Qualifications:

Education and Experience: Bachelor's degree in psychology, social work, human services, or a relevant field required, or equivalent qualifying experience in county behavioral health documentation, billing, or quality assurance. One (1) year of experience working within a contracted or directly operated county behavioral health program serving high-risk children, youth, and families; OR one (1) year of experience reviewing or overseeing county behavioral health billing, documentation, client records, quality assurance, policies and procedures, and training protocols. Required.

Demonstrated knowledge of Medi-Cal specialty mental health documentation and claiming requirements, including EPSDT medical necessity and progress note standards. Experience conducting chart reviews and providing corrective feedback and training to clinical staff. Experience supporting county monitoring visits, audits, or corrective action plans preferred. Familiarity with evidence-based practice fidelity monitoring. Experience with PCIT or comparable model fidelity systems preferred. Bilingual in English and Spanish, or another language prevalent in the ATLAS priority ZIP code communities, preferred. Valid California Driver’s License with a minimum of three (3) years of good driving history and must be approved by the agency’s insurance carrier to drive agency vehicles.

Benefits:

Wayfinder is committed to providing our employees with a benefits program that is both comprehensive and competitive which includes:

• Paid Time Off: Generous Paid Time Off (PTO) policy, 11 paid holidays, plus five winter holidays
• Medical, dental, vision, life, and long-term disability insurance
• 401(k) retirement plan with employer match up to 4%
• Employee referral program: Encourage your colleagues to join us
• Public Service Loan Forgiveness (PSLF) eligible
• Flexible spending account (FSA) plans

Eligibility and other benefits are outlined in plan documents. Wayfinder Family Services is an Equal Opportunity Employer. We support a drug-free workplace and conduct pre-employment background and drug screenings.