QA​/Improvement Specialist

The Village is accredited by the International Commission on Accreditation of Rehabilitation Facilities (CARF) for its Adoptions, Foster Care, Mental Health, Wraparound, and Drop-In Center services. We deliver evidenced-based behavioral health services to children, youth and adults, and has long been at the forefront of culturally sensitive foster care and adoption services.

This is an exciting opportunity to become part of team in a growing organization. We offer competitive compensation packages, including benefits such as health insurance, retirement plans, and paid time off. If you are a motivated individual with a passion and a desire to drive positive change within an organization,

The Quality Compliance and Improvement Specialist is responsible for monitoring and strengthening compliance with regulatory requirements, contractual standards, (e.g., Medi-Cal/DCFS), clinical expectations, and internal policies. Through structured audits, data analysis, utilization review, and clinical documentation review, the role identifies trends, evaluates effectiveness, and supports continuous quality improvement. The position also provides training and technical assistance to staff to ensure accurate documentation and regulatory compliance.

Responsibilities may include developing documentation tools, maintaining program records, tracking data, preparing reports and outcome measures, and providing technical assistance to departmental programs. The role operates under the direction of the Quality Assurance Director.

• Master's Degree in a behavioral health field required
• Active ASW, AMFT, APCC, or licensed (LCSW, LMFT or LPCC)
• Minimum 2 years' experience with LA County DMH documentation and Medi-Cal billing
• Familiarity with Electronic Health Records (EHR)
• A combination of training and experience exhibits the knowledge, skills, and abilities necessary to perform the essential duties of this position
• QA, utilization review, or compliance experience
• Hybrid work schedule. Minimum 50% in office; the work schedule will be determined by the Director of Quality Assurance.

All of the responsibilities listed below are considered essential functions of this position. Additionally, this position is expected to ensure adherence to the core operating values and the strategic direction of the agency.

• Conduct comprehensive department audits across agency programs including behavioral/mental health, child welfare, housing, and adjunct services. Responsibilities include, but are not limited to, utilization reviews, records review, audit readiness, data analysis, etc., to ensure compliance with Federal, State, and County, Medi-Cal, BHSA, HIPAA, and all applicable regulatory and contractual requirements.
• Maintain current knowledge of clinical documentation standards, regulatory updates, and payer requirements; implement updates and ensure agency-wide adherence.
• Identify documentation deficiencies, compliance risks, and billing discrepancies; ensure timely corrective actions and follow-up with clinicians and supervisors.
  
  Evaluate medical necessity, service appropriateness, and treatment effectiveness through clinical record review.
• Maintain audit tracking systems and ensure proper documentation of review outcomes, corrective actions, and compliance status.

• Support and assist in the implementation of agency-wide quality improvement (QI), utilization review (UR), risk management, safety, and clinical records review processes.
• Analyze audit findings and performance data to identify trends, systemic issues, and opportunities for improvement.
• Collaborate…