Following a 2022 merger of CNSI and Kepro, Acentra Health combines clinical services, technology solutions, and data analytics to accelerate better health outcomes. This is a great time to join our team of passionate individuals working together to pursue the most effective solutions to today’s complex healthcare challenges. Our culture is fueled by passion and driven by purpose.Position OverviewPASRR Level II Quality Assurance Manager, responsible for ensuring the overall consistency, thoroughness, and accuracy of Level II evaluations. Acts as the primary liaison between DHCS and contractors on matters related to psychosocial, clinical social work, and placement alternatives. Provides additional training as necessary to enhance evaluator performance and monitors performance accordingly. Conducts clinical quality certification reviews for Level II evaluations before submission to DHCS. Develops, implements, and oversees an effective quality management program encompassing evaluator credentialing, clinical training, and performance tracking/reporting activitiesImportant: Work Hours: Wednesday – Sunday 11am – 8pm, including some holidaysJob Responsibilities:
Manage the daily workload for the quality review process, ensuring timely completion in accordance with contract requirements.
Ensure accurate PASRR evaluations through comprehensive clinical assessment of patients, relevant records, and collateral sources of individuals with suspected or confirmed mental illness to determine the presence of Serious Mental Illness (SMI), as defined by 42 CFR 483.102(b)(1). Ensure accurate PASRR review completion by determining the appropriate level of care based on the patient’s physical, behavioral, and psychological functioning.
Conduct screenings and complete PASRR evaluations efficiently and accurately.
Ensure compliance with necessary workflows, including re-review of records based upon input from the Medical Director.
Respond promptly to state inquiries regarding evaluations conducted.
Assessment and analysis of psychological, emotional, behavioral, and physical functioning to develop level of care recommendations based on clinical evaluations
Attend and actively participate in staff meetings, conducting case consultations, peer reviews, and internal auditing.
Stay abreast of current literature, regulations, and research related to long-term care, mental illness, medical conditions, and geriatrics.
Provide oversight, feedback, and training for evaluators as needed to ensure Level II evaluations are completed appropriately, and evaluate the effectiveness of training.
Assessment and analysis of psychological, emotional, behavioral, and physical functioning.
Create, establish, and chair a Quality Improvement (QI) committee that reports on all QI activities.
Provide supervision to Evaluators and/or care coordinators as required.
Conduct monthly record reviews to identify patterns of quality concern.
Note: The list of accountabilities is not intended to be all-inclusive and may be expanded to include other duties that management may deem necessary from time to time.
Required Qualifications; Licensed, Knolwedge, Skills, and Experience
Licensed Clinical Social Worker, Licensed Clinical Psychologist, Nurse Practitioner, or other qualified Licensed Mental Health Professional approved by the state PASRR authority.
Graduation from an accredited college with a relevant degree program.
Minimum of 3 years’ experience in assessing and diagnosing individuals with mental/psychiatric disorders, including complex differential diagnoses related to substance use, medical conditions, cognitive issues, and dementia.
Experience working with the geriatric population.
Familiarity with psychiatric disorders as per the latest Diagnostic and Statistical Manual used in California.
Basic Knowledge of Federal Regulation 42 CFR, Chapter 483.
Ability to determine clinical diagnoses, considering psychological and behavioral factors
Knowledge and understanding of public sector services and supports.
Knowledge of psychiatric disorders as defined by the most current Diagnostic and Statistical Manual used in California.
Knowledgeable about standards of practice related to mental health, geriatric, and other disorders necessitating long-term care placement.
Knowledge of standards of practice related to mental health, geriatric, and other disorders typically requiring long-term care placements.
Understanding of standards of practice related to determination of the level of care.
Effective interaction with office staff to support necessary workflows.
Communicate effectively with healthcare professionals, patients, families, and other support networks.
Clear and effective communication through spoken, written, and electronic media.
Detail-oriented, with the ability to prioritize and execute tasks in a timely manner.
Effectively utilize computer equipment and web-based software for work tasks.
Attention to detail, prioritization skills, and timely execution of tasks.
Proficiency in Microsoft Office Suites,
Why us?Acentra Health is a rapidly growing national quality improvement and care management organization. We work to ensure that over 20 million people receive the right care, at the right time, in the right setting. Singularly Focused. Mission Driven. Accelerating Better Outcomes is our Mantra! We are mission-driven to innovate health solutions that deliver maximum value and impact. We do this through our people.You will have meaningful work that genuinely improves people's lives across the country. We are a company that cares about our employees, and we give you the tools and encouragement you need to achieve the finest work of your career.Benefits are a key component of your rewards package. Our benefits are designed to provide you with additional protection, security, and support for both your career and your life away from work. Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts, and more. CompensationThe compensation for this role is $88,000 to $93,500 annual base salary. Based on our compensation program, an applicant’s position placement in the pay range will depend on various considerations, such as years of applicable experience and skill level. EOE AA M/F/Vet/Disability Acentra Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran or any other status protected by applicable Federal, State or Local law.We know your time is valuable and we thank you for applying for this position. Due to the high volume of applicants, only those who are chosen to advance in our interview process will be contacted. We sincerely appreciate your interest in Acentra Health and invite you to apply to future openings that may be of interest. Best of luck in your search! The Acentra Health Talent Acquisition Team
