Quality Management & Utilization Specialist

ChangePoint Integrated Health Centers; Show Low (AZ); On-site; USD 42,000 - 65,000; Full time

Job summary

ChangePoint Integrated Health Centers is seeking a Quality Management/Utilization Management Specialist (QM/UM Specialist) to conduct chart reviews, monitor regulatory compliance, and assist in QM/UM planning. This non-exempt role collaborates with leadership to ensure quality and safety across medical records and utilization management processes.

The position requires a High School Diploma, Arizona driver’s license, and 1 year in behavioral health, with preferred Bachelor's in behavioral health

Qualifications

• High School Diploma required.
• Current Arizona Driver's License required.
• 1 year experience in a behavioral health agency.
• Must comply with Drug Free workplace.
• Must be 21 years of age.

Responsibilities

• Adhere to personnel policy and comply with agency requirements for ethical and professional behavior.
• Participate in QM System implementation and in the development of the annual Evaluation and Plan.
• Assist in implementing hospital QM and UM systems and developing the annual Evaluation and Plan.
• Assist in development and revision of policies and procedures as needed.
• Be a resource to clinicians and administrative staff regarding record standards.
• Produce verbal and written reports and visual graphs reflecting data analysis.
• Work as a team to help staff understand and comply with record standards.
• Be accurate, efficient, and complete in documentation.
• Support the company, patients, families and co-workers through quality management activities.
• Perform chart reviews and audits as needed.
• Review and release of medical records ensuring HIPAA rules and regulations are adhered to.
• Promote quality and safety to maintain a safe and pleasant work environment.
• Perform other duties as assigned by supervisor.

Skills

English fluency

Verbal and written communication

Analytical skills

Time management

Team player

Documentation accuracy

Education

High School Diploma

Bachelor's Degree in Behavioral Health or related

Tools

Microsoft Office

Job description

ChangePoint Integrated Health Centers is seeking a Quality Management/Utilization Management Specialist (QM/UM Specialist) to conduct chart reviews, monitor regulatory compliance, and assist in QM/UM planning. This non-exempt role collaborates with leadership to ensure quality and safety across medical records and utilization management processes.

The position requires a High School Diploma, Arizona driver’s license, and 1 year in behavioral health, with preferred Bachelor's in behavioral health