Remote QA & Risk Coordinator - Behavioral Health

Commonwealth of PA; Harrisburg (Dauphin County); Hybrid; USD 55,000 - 75,000; Full time

Benefits offered by this job

Health insurance plans

Retirement plans

Paid leave and flexible schedules

Work-from-home opportunities

Employee discounts

Job summary

The Commonwealth of Pennsylvania's Department of Human Services seeks a Quality Assurance Risk Management Coordinator to evaluate programs and improve behavioral health services across the state.

The role offers the possibility of telework up to 3 days per week, a standard 8:00 AM–4:30 PM schedule, and collaborative work with internal and external partners to enhance care quality. Harrisburg headquarters option is available.

Qualifications

• One year as a Quality Assurance/Risk Management Specialist or equivalent Federal Government title.
• Three years of professional experience on a multidisciplinary treatment team in health care setting and a bachelor’s degree.
• Three years of clinical experience in a human services agency with administrative/evaluative/supervisory work and a related bachelor’s degree.
• Any equivalent combination of experience and training.

Responsibilities

• Program Reviews: Examine contractor and managed care operations for compliance with rules.
• Data Evaluation: Assess documents and reports to ensure standards and benchmarks are met.
• Compliance Monitoring: Review service decisions for medical necessity and clarity.
• Onsite Audits: Lead audits and interviews to evaluate access, quality, and risk in behavioral health services.
• Collaboration Efforts: Work with internal and external partners on quality reviews and best practices.
• Policy Analysis: Study legislative changes and interpret their impact on services.

Skills

QA/Risk management

Interdisciplinary teamwork

Clinical experience

Program evaluation

Education

Bachelor's degree in health care administration

Bachelor's degree in social work or related field

Job description

The Commonwealth of Pennsylvania's Department of Human Services seeks a Quality Assurance Risk Management Coordinator to evaluate programs and improve behavioral health services across the state.

The role offers the possibility of telework up to 3 days per week, a standard 8:00 AM–4:30 PM schedule, and collaborative work with internal and external partners to enhance care quality. Harrisburg headquarters option is available.