Clinical Quality Analyst - DMH Inpatient Programs

Gateways Hospital and Mental Health Center; Los Angeles (CA); On-site; USD 95,000 - 125,000; Full time

Job summary

Gateways Hospital and Mental Health Center in Los Angeles is seeking a Clinical Quality Analyst to support inpatient psychiatric programs contracted with the Los Angeles County Department of Mental Health.

The analyst reviews patient safety, quality of care, and contractual compliance, conducts chart reviews, and collaborates with clinical leadership to identify risks and support quality improvement initiatives.

Responsibilities

• Conduct comprehensive inpatient psychiatric chart reviews to ensure compliance with clinical standards, medical necessity criteria, evidence based practices, and contractual regulatory requirements.
• Support timely admission medical necessity reviews and continued stay reviews to assess ongoing appropriateness of inpatient level of care.
• Review, analyze, and interpret clinical, utilization, and safety data 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.
• Identify documentation gaps, quality of care deficiencies, or compliance issues and recommend corrective actions to improve outcomes and safety.
• 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 and maintain audit tools and criteria.
• Prepare and present quality, utilization, and compliance findings to program leadership and Quality Improvement stakeholders.
• Maintain current knowledge of DMH inpatient psychiatric regulations and documentation standards, adjusting activities as requirements evolve.

Job description

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.