1+ months

Behavioral Health Quality of Care Reviewer - Phoenix, AZ - 902442

Phoenix, AZ 85003
  • Job Code
    902442
UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm)

This position will be responsible for reviewing medical records as they relate to Quality of Care investigations including tracking and trending of incidents related to Behavioral Health. This will include responding to quality improvement inquiries from AHCCCS.

This position is located on-site at 1 East Washington Street in Phoenix, AZ with about 25% travel within the area.

Primary Responsibilities:

  • Review" and audit Behavioral Health quality of care chart and medical records from" providers regarding deviations from established standards of care
  • Monitor" the production of quality results reporting; analyze, track and trend the reporting" results and assess need for corrective action plans and follow up
  • Formulate" and prepare ad-hoc and additional reporting requirements including report" presentation to Provider Advisory Committee (PAC) and other sub committees
  • Recommend," develop, and implement quality improvement plans with providers and follow" up as necessary
  • Train" providers and staff in methodologies and tools of continuous quality" improvement
  • Prepare" for and participate in meetings with State agencies, providers, and" stakeholders as well as internal meetings
  • Perform" behavioral health audits to meet state and internal requirements and" required turnaround times
  • Complete" reviews in the AHCCCS IAD portal and Care Todays as required in statutory" timelines
  • This position will have" provider location visits as needed for health and safety checks and" immediate jeopardy
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You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required"Qualifications:

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  • Master's degree in related field of Psychology,"Social Work or Addiction Medicine
  • 3+ years in the AZ behavioral health field with"a provider or health plan
  • 2 + years' experience reviewing medical record"charts/documentation and writing regulatory reports
  • Proficiency in software applications that"include, but are not limited to, Microsoft Word, Excel and Teams
  • Critical thinking, comfortable in presenting"reports to medical directors and committees
  • Licensed by AZ Board of Behavioral Health
  • Must reside in AZ.
  • Reliable transportation for field visits
  • If you need to enter a work site for any reason,"you will be required to screen for symptoms using the ProtectWell mobile app,"Interactive Voice Response (i.e., entering your symptoms via phone system) or"similar UnitedHealth Group-approved symptom screener. When in a UnitedHealth"Group building, employees are required to wear a mask in common areas. In"addition, employees must comply with any state and local masking orders
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Preferred"Qualifications:

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  • Certified" Professional in Health Care Quality (CPHQ)
  • Arizona Licensed Clinical" Social Work (LCSW), Licensed Professional Counselor (LPC), Arizona" Licensed Marriage and Family Counselor (LMFT)
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Careers with"UnitedHealthcare.Let's talk about"opportunity. Start with a Fortune 7 organization that's serving more than 85"million people already and building the industry's singular reputation for bold"ideas and impeccable execution. Now, add your energy, your passion for"excellence, your near-obsession with driving change for the better. Get the"picture? UnitedHealthcare is serving employers and individuals, states and"communities, military families and veterans where ever they're found across the"globe. We bring them the resources of an industry leader and a commitment to"improve their lives that's second to none. This is no small opportunity. It's"where you can doyour life's best work.(sm)

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For more information on"our Internal Job Posting Policy, clickhere.

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Diversity creates a healthier atmosphere: UnitedHealth Group is an"Equal Employment Opportunity/Affirmative Action employer and all qualified"applicants will receive consideration for employment without regard to race,"color, religion, sex, age, national origin, protected veteran status,"disability status, sexual orientation, gender identity or expression, marital"status, genetic information, or any other characteristic protected by law.

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UnitedHealth Group is a drug-free workplace. Candidates are"required to pass a drug test before beginning employment.

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Job Keywords: Behavioral"Health, Mental Health, Quality Review, CPHQ, Medicaid, Phoenix, AZ, Arizona

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Categories

Posted: 2020-12-16 Expires: 2021-03-14

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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Behavioral Health Quality of Care Reviewer - Phoenix, AZ - 902442

UnitedHealth Group
Phoenix, AZ 85003

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