Advantage Behavioral Health Systems

Role Description Under the Quality Improvement Department, the Quality Care Auditor reviews client records to evaluate the documentation justifying service necessity, compliance with federal and state guidelines, accreditation standards, and ABHS policy. This position assists with the provision of scheduled training on documentation and will also assist with the preparation for and facilitation of external fidelity audits and other compliance reviews. Assists with input of data and generates reports to document errors and trends. Performs daily tasks with minimal supervision. Job Responsibilities and Performance Standards - Serves as clinical resource in Behavioral Health/Addictive Disease & Intellectual Developmental Disability Practices to ensure compliance with regulations, standards, and policies. - Conducts internal audits to include Peer and Quality Reviews. - Conducts internal audits to ensure Programmatic Integrity based on ERO (External Review Organization) and agency standards. - Assists with audits and reviews of agency oversights and payors. - Identifies trends, training needs, and areas for improvement. - Collaborates with Quality Care Coordinator to develop new training for various types of staff. - Reviews clinical documentation (e.g. assessment, progress note, treatment plan) for required ERO and agency standards and communicates with supervisors and staff to identify training needs. - Performs internal audits, including quarterly peer reviews and monthly quality reviews, using established criteria to determine specific and overall issues related to compliance and/or training needs. Shares information with responsible clinician/supervisor and assists in formulating plans for correction/training. - Maintains a good working relationship with physicians/clinicians/admin support/business office and others to keep them informed about new rules and regulations. - Acknowledges and responds to requests for information in a timely manner. Attends regular agency and program staff meetings to disseminate information and provides support. - Other duties as assigned by Quality Care Coordinator. Qualifications - Master’s degree in counseling, social work, psychology, or closely related field and 2+ years of professional experience in a Behavioral Health/Addictive Disease/Intellectual Developmental Disabilities setting. - Knowledge of DBHDD provider manual and guidelines. - Proficient use of Electronic Health Record systems. Preferred Qualifications - Full licensure and/or certification in one or more counseling, social work fields. - Proficient use of Microsoft applications (Excel, Power Point, Word).

Role Description Under general supervision, performs complex administrative duties and statistical, financial, or operations data analysis and reporting in support of management decision making within the functional area. Identifies trends, discrepancies and variances to improve the efficiency and effectiveness of operations. May partner with other departments, divisions, outside agencies, and vendors to address business issues. Exercises various latitudes of independent judgement. May administer or provide high level support for various projects, grants, contracts, implementation of procedures and/or any specialized functions. Assists with orientation, training, or providing task guidance of junior team members. Job Responsibilities and Performance Standards - Processes and answers Sys Aid Tickets regarding authorizations and write-off requests as submitted by staff. - Runs daily, monthly, quarterly reports including but not limited to expiring auths, no auths, registrations lapsed, CMO requests, Void status, Pend status, KPI dashboard (CMO & VA). - Research and works on reports for correction and trends, communicating actions and trends to programs and supervisors. - Monitors Care Management Auth email for authorization manual uploads and 15-day report from Carelon. - Monitors CMO/Medicare Teams Chat. - Submits Requests for Services onto the HealthShare Referral Manager (HRSM) system for VA clients. - Monitors HealthShare Referral Manager (HRSM) for tasks assigned from VA, uploads required documentation for VA clients. - Coordinates with Centralized Scheduling for new VA referrals and kept appointments. - Submits Outpatient Treatment Requests on GAMMIS portal. - Downloads approved authorizations from GAMMIS portal. - Batches and loads ASO authorization requests and response files. - Completes concurrent ASO authorization requests for Outpatient clinics. - Research and works rejections from ASO, CMO, and VA authorization requests. - Collaborate with Care Management Department staff for clinical review and guidance with authorization requests, rejections, denials, etc. - Tracks Women’s Residential and Transition Registrations and Authorizations. - Other duties as assigned. Qualifications - High school diploma or GED AND 2 years of experience required at the lower-level position or position equivalent. - Must show ability to lead and supervise a team.

Job DetailsLevel: EntryJob Location: Augusta Area (Remote) - Augusta, GA 30912Position Type: Full TimeJob Shift: DayPosition Summary: This position will schedule, coordinate, and facilitate housing opportunities for consumers through housing development activities to include housing stability case management and skill building, community integration supports and advocacy toward the attainment of mainstream service supports appropriate to the needs and eligibility of each program participant. Duties and Responsibilities: Help complete applications of various rental housing resources primarily the Georgia Housing Voucher Program, as well as HUD funded programs administered by the Department of Community Affairs and local Public Housing Authorities Housing search activities to include the following: contacting prospective landlords to schedule initial application processes; schedule housing interviews for consumers; assist with rental application process Assist with transportation and system navigation skill to assist with documentation necessary to qualify for housing. Transport clients as deemed necessary. Transportation requirements should be limited to housing and job searches and occasional visit to relevant social service agencies. Help consumers meet tenancy obligations such as timely rent payments and other lease requirements Provide follow up services to consumers in maintaining their homes by providing periodic in-home visits Provide referrals and care linkage to help clients maintain contact with services for disability applications and employment Provie information and referral assistance regarding available support from appropriate social service agencies and/or community programs Assist in the development of and encourage adherence to a personal budget through proactive housing and budget counseling sessions; provide budget counseling and education to assist clients in establishing payment plans for bills and past debts to assist clients in obtaining and maintaining housing Assist participants in development of a strength-based/solution-focused individualized goal and action plan that promotes permanent housing and self-sufficiency; develop an effective, timely referral network in order to ensure ongoing direction and support as needed. Identify participant strengths and barriers to stability and assist participants to reducing barriers and linking to resources and services. Provide pro-active follow-up home visits to ensure stability and further progress towards self-sufficiency; this includes support, advocacy, reducing isolation, listening, problem solving, and identification of resources to assist with reintegration of participants in the community. Apply knowledge of residential lease contracts to educate clients of their rights and responsibilities. Maintain accurate daily logs records, monthly outcome reports, and files for each client. Other Responsibilities: Maintain a complete working file providing activity documentation and copies of all corresponding paperwork. Attend and participate in monthly staff meetings with Regional Field Office and central Office of Supportive Housing, group supervision, and individual supervision as required by the program Attend and participate in trainings as required to promote ongoing professional growth and development Complete and submit incident reports to the Supervisor within 24 hours of an incident occurring as required by the program QualificationsMinimum Qualifications: Bachelors level degree in Social Work, Public Administration, or other related field. Proven experience can be substituted for formal education. Certified Peer Specialists are strongly encouraged to apply. Must have access to a personal vehicle and a valid state Drivers License Preferred Qualifications: 1-3 years working in homeless services and/or working within the behavioral health field. Experience providing housing services and/or community mental health services. Knowledge of and/or proficiency with ClientTrack Homeless Management Information System and the Coordinated Entry process. A passion for connecting with people experiencing homelessness is a must.