Clinical Quality Analyst - DMH Inpatient Programs

GATEWAYS HOSPITAL & MENTAL HEALTH CENTER; Los Angeles (CA); On-site; USD 82,000 - 90,000; Full time

Benefits offered by this job

Medical/Dental/Vision benefits

Paid holidays

Vacation days

401k match

Annual company events

Job summary

Gateways Hospital & Mental Health Center in Los Angeles seeks a Clinical Quality Analyst to support inpatient psychiatric programs contracted with the DMH. You will review patient records for safety, quality of care, and regulatory compliance, and collaborate with leadership to address risks.

Responsibilities include chart reviews, utilization reviews, data interpretation, and presenting findings to program leadership; requires 3–5 years in behavioral health and a state-credentialed license or

Qualifications

• 3-5 years of postgraduate clinical experience in behavioral health.
• At least 2 years in clinical quality review, utilization management, compliance/audit, risk management, or program monitoring.
• Knowledge of Los Angeles DMH inpatient psychiatric requirements.

Responsibilities

• Conduct inpatient psychiatric chart reviews to ensure DMH compliance and medical necessity.
• Support admission medical necessity reviews and continued stay reviews.
• Review and interpret clinical, utilization, and safety data to identify trends and risk areas.
• Facilitate Utilization Review and quality committees with clinical findings and recommendations.
• Identify documentation gaps and propose corrective actions to improve patient outcomes and regulatory adherence.
• Provide coaching and training to clinical staff on documentation standards and regulatory requirements.
• Collaborate with Quality Improvement staff to support continuous quality improvement initiatives.
• Prepare and present quality, utilization, and compliance findings to leadership and committees.

Skills

Postgraduate clinical experience

Clinical quality review

Utilization management

Compliance / audit

Risk management

Program monitoring - publicly funded

Education

Master’s degree in behavioral health

Clinical license or license eligible

Job description

Job Details: Job Location: Main Hospital - Los Angeles, CA, Salary Range: $82000.00 - $90000.00Salary/year,

Title of Position: Clinical Quality Analyst -DMH Inpatient Programs

Location: Gateways Hospital & Mental Health Center

Exempt/Non-Exempt: Exempt

Union/Non-Union: Non-Union

Supervisor: Clinical Quality Manager

SUMMARY OF POSITION

The Clinical Quality Analyst supports clinical care teams in providing high quality, safe care for patients in inpatient psychiatric programs contracted with the Los Angeles County Department of Mental Health. The Clinical Quality Analyst is responsible for reviewing, analyzing, and interpreting information related to patient safety, quality of care, and contractual and regulatory compliance. The Analyst conducts patient chart reviews and collaborates with clinical leadership and other Quality Improvement Department staff to identify and address potential risk, support quality improvement initiatives, and ensure compliance with all applicable contractual and regulatory requirements.

ESSENTIALS DUTIES

• Conduct comprehensive inpatient psychiatric chart reviews, including admission, concurrent, discharge, safety, peer, and ad-hoc reviews, to ensure compliance with clinical standards, medical necessity criteria, evidence based practices, and applicable Department of Mental Health (DMH) contractual and regulatory requirements.
• Support with timely admission medical necessity reviews and continued stay reviews to assess ongoing appropriateness of inpatient level of care, including completion of administrative day processes when applicable.
• Review, analyze, and interpret clinical, utilization, and safety data (e.g., patient records, incidents, length of stay indicators) to identify trends, quality concerns, utilization issues, and risk areas.
• Facilitate or participate in Utilization Review and related quality committees, providing clinical analysis, findings, and recommendations to support appropriate care delivery and resource utilization.
• Identify documentation gaps, quality of care deficiencies, or compliance issues and recommend corrective actions to improve patient outcomes, safety, and regulatory adherence.
• Provide coaching, consultation, and training to clinical staff and leadership regarding documentation standards, medical necessity, quality expectations, and regulatory requirements.
• Collaborate with Quality Improvement staff to support continuous quality improvement initiatives, maintain audit tools and criteria, and promote consistent application of inpatient quality standards.
• Prepare and present quality, utilization, and compliance findings to program leadership, committees, and Quality Improvement stakeholders.
• Maintain current knowledge of DMH inpatient psychiatric regulations, contractual requirements, and documentation standards, adjusting review activities as requirements evolve.
• Maintain confidentiality, legal privilege, and data security related to all clinical, utilization, and quality information, and perform other related duties as assigned consistent with the scope of the role.
• Performs other additional task as directed.

Qualifications: EXPERIENCE/QUALIFICATIONS

• 3-5 years of postgraduate clinical experience in behavioral health.
• At least 2 years in one or more of the following:
  • Clinical quality review
  • Utilization management
  • Compliance or audit functions
  • Risk management
  • Program monitoring in publicly funded behavioral health systems
• Knowledge and experience of Los Angeles County Department of Mental Health (DMH) inpatient psychiatric requirements.

EDUCATION & CERTIFICATES

• Master’s degree in psychology, Social Work, or other behavioral health field required.
• Clinical license (e.g., Licensed Psychologist, LCSW, LMFT, LPCC) or license eligible (e.g., Waivered Psychologist, ASW, AMFT, APCC) required.

REQUIREMENTS

• Must pass Department of Justice (DOJ), Federal Bureau of Investigations (FBI), and Community Care Licensing (CCL) background clearance.
• Valid California Driver’s license.
• TB clearance.
• Driving record acceptable for coverage by Gateways insurance carrier.

Gateways believes that our people are our greatest asset and is proud to offer competitive benefits that support their health, happiness and career development.

• Cover 100% Medical/Dental/Vision Premiums for all Full-Time Employees and 1 Dependent
• 8 Paid Holidays + 4 Personal Holidays in Calendar Year
• 2 Weeks of Vacation
• 403b Retirement Plan Company Match 8%
• Annual Company Events