Clinical Quality Assurance Specialist

About the role

The Quality Assurance (QA) Specialist ensures the delivery of high-quality, compliant, and data-driven behavioral health services across Crittenton’s programs. This role leads clinical chart audits, contract compliance reviews, performance monitoring, and data analysis to ensure compliance with LACDMH, Medi-Cal/CalAIM, DCFS, CDSS, and other regulatory requirements.

Responsibilities

• Conduct ongoing audits of clinical documentation to ensure compliance with LACDMH, Medi-Cal, HIPAA, and contractual standards.
• Monitor contract compliance across programs, ensuring services align with funding requirements, service delivery expectations, and reporting obligations.
• Support quality assurance and compliance monitoring for THP, Foster Care, and other agency programs, ensuring adherence to DCFS, CDSS, and regulatory standards.
• Participate in LACDMH chart reviews and support organizational responses to corrective action plans.
• Train staff on documentation standards, medical necessity, and compliance expectations.
• Ensure ongoing compliance with DMH, CalAIM, HIPAA, The Joint Commission, Community Care Licensing, CDSS, and BBS standards.
• Maintain current knowledge of LACDMH QA bulletins, contract requirements, and regulatory updates across programs.
• Aid in preparation for external audits, licensing inspections, and accreditation reviews across mental health, THP, and foster care services.
• Assist with development and revision of agency policies to maintain compliance across all service lines.
• Collect, analyze, and interpret clinical, operational, and outcome data across multiple programs.
• Develop and maintain dashboards tracking KPIs, compliance indicators, and contract performance metrics.
• Identify trends, gaps in care, and compliance risks, and provide actionable recommendations to leadership.
• Produce reports, executive summaries, and performance metrics to support decision-making.
• Support development and monitoring of Key Performance Indicators (KPIs) related to quality, safety, documentation, and contract performance.
• Lead or support Continuous Quality Improvement (CQI) initiatives across mental health and related programs.
• Monitor progress of improvement initiatives and assist programs in implementing sustainable changes.
• Participate in root cause analyses (RCA) for incidents, complaints, and compliance issues.
• Monitor corrective action plans and evaluate effectiveness of interventions.
• Identify trends in incidents across programs and provide recommendations to reduce risk and improve service delivery.
• Maintain accurate, organized records of audits, findings, compliance activities, and corrective actions.
• Ensure all documentation is audit-ready for DMH, Medi-Cal, licensing, and accreditation reviews.

Qualifications

• Master’s degree in Social Work, Marriage and Family Therapy, Psychology, or related behavioral health field (required); licensed (LCSW, LMFT, LPCC) preferred.
• Minimum of 2-3 years of experience in quality assurance, data analysis, or clinical auditing within behavioral health or social service settings.
• Strong knowledge of LACDMH documentation standards, CalAIM, CDSS, and DCFS requirements.
• Experience working in PEI, Wraparound, Community Mental Health, ECM, Group Home, THP, Foster Care, Family Preservation, or similar programs required.
• Experience with EHR systems and Medi-Cal documentation standards required.
• Experience with data visualization tools (Power BI, Tableau, dashboards) preferred.

Clearances and Requirements

• Must successfully clear DOJ and FBI fingerprint checks.
• Must be at least 21 years of age.
• Valid California driver’s license and current auto insurance.
• Ability to work across office, residential, and field-based environments.
• Capacity to conduct site visits, audits, and quality inspections as needed.

Pay

Pay Range: $75,000.00 - $88,000.00 annually