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Behavioral Health Services Quality Review Consultant

Pasadena, California

Mental health is an essential component of total health. As mental health professionals, we’re on the front lines every day, using the latest advances to help those in need. If you share our passion for care and our commitment to helping those around us, you’ll have the resources you need to make a real difference. Our services include adult and child therapy as well as help with addiction and eating disorders.

  • Job Type: Full-time
  • Job Level: Individual Contributor
  • Travel: Yes, 10 % of the Time

Success Profile

These are the traits of the most successful members of our behavioral health team.

  • Adaptable
  • Compassionate
  • Good listener
  • Proactive
  • Results driven
  • Versatile

Benefits

Our compensation and benefits are designed to help you and your family stay healthy and thrive in and beyond work.

  • Medical, Vision & Dental

  • Professional Development

  • Retirement Plans

  • Vacation, Holiday & Sick Leave

  • Supportive Teams & Resources

NOTE: Benefits may vary based on your Kaiser Permanente region, position, scheduled hours, and representation by collective bargaining or employee groups. *Offerings vary by location.

Our Culture

We offer a mental health environment that's unique both in the way we treat our patients and in the way we support our health care professionals. Here, we practice evidence-based care in a team setting that’s focused on the needs of the individual, the family and the population as a whole. This gives your patients the opportunity to work towards achieving their physical, mental, and behavioral health goals. On our teams, we hold social justice as a shared value and are committed to addressing and eliminating stigma associated with mental health and addiction. Working as part of a team also helps support your own career growth while you provide high-quality strengths-based, brief, solution-focused, and episodic mental health care.

What Our Employees Say

Aaron M.

Aaron

Psychiatric Social Worker

Kaiser Permanente has been an excellent platform for me to grow as a professional. The organization has demonstrated its commitment to the continued growth of its employees through the training it offers and encourages. I’ve always resonated with the organization’s integrated approach to health care, and its recognition of how essential good mental health is to a person’s overall well-being.
Breeza Q.

Breeza

Licensed Certified Social Worker

I would recommend and do recommend working for Kaiser Permanente. It’s a professional, clean, friendly, fast-paced environment and there is a real trust and respect for clinical staff no matter what role we serve. I love feeling valued and heard and am thankful to have found an environment that provides that.
Janice G.

Janice

Licensed Marriage & Family Therapist

This is the best place to work because of the commitment to the total health of our members, the work/life balance, the possibilities to use clinical skills in a variety of capacities within the organization and opportunities for personal and professional growth. As employees of Kaiser Permanente, we all have a voice and are encouraged to use it.
Gabriela A.

Gabriela

Clinical Program Manager

At Kaiser Permanente, I have opportunities to learn and work in a professional setting with people who are passionate about patient care. I love my career as a therapist and now as a manager! I really enjoy helping others and learning new interventions and modalities. These ensure my personal and professional growth.
Laura H.

Laura

Psychotherapist

Kaiser Permanente is a health care leader who sets trends and makes a difference in industry practices and protocols. I like the extraordinary resources available to do my job, the servant leadership of my manager and director, and the high standard of business and clinical ethics.
Amie L.

Amie

PsyD, Clinical Psychologist

We’re an innovative, vision-forward company. While Integrative-Care models are relatively new, we’ve been on the frontlines of building out a high-functioning integrated team for over a decade. Within this model of care, we’re pushed to think out of the box when it comes to patient care, be collaborative, and succeed in a fast-paced environment.
Carol S.

Carol

PhD, Licensed Certified Social Worker – Clinical

Kaiser Permanente demonstrates its commitment to their employees’, has a top-notch salary and compensation package, and has a leadership body that is well trained and supportive. As a Clinician and a Manager, I am very impressed with our commitment to quality outcomes. I have truly found a home here and would be honored for Kaiser Permanente to be my last professional stop in my career.
Michael V.

Michael

PsyD, Licensed Marriage and Family Therapist, Psych Social Worker

Kaiser Permanente, in my opinion, is a great mix of professional, friendly and fast-paced. They allow me to be who I am and let me have a voice. I love being a therapist and I’m very proud and excited about the Gender Assessments and transgender group work being conducted. I’m helping the LGBT community and making this population feel comfortable throughout their care journey. Kaiser Permanente is a breath of fresh air to me in my work.
Kashonda D.

Kashonda

Psychotherapist

I appreciate how Kaiser Permanente strives to reflect inclusivity and representation throughout the organization. I’m excited about an internal clinic comprised of African American clinicians dedicated to supporting the health needs of the African diaspora. I’m proud to be part of committees that intentionally promote equity, inclusion and diversity. These things combined with the benefits, opportunities and people make Kaiser Permanente a great place to work.

Behavioral Health Services Quality Review Consultant

Primary Location Pasadena, California Job Number 1149686 Date posted 01/24/2023
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Description:
Job Summary:

The Behavioral Health Quality Reviewer conducts and coordinates quality review activities for behavioral health services. Provides clinical review, educational, consulting, and coordinating support to assigned areas.  Coordinates with physicians, staff, and non-Kaiser providers and facilities regarding assessment of clinical care paths. In conjunction with physicians, monitors all clinical activities, makes recommendations, identifies cost-effective protocols, and develops guidelines for care.

Essential Responsibilities:


  • Performs concurrent review of ambulatory service records based on care standards and the level of care (LOC) needed (long term vs short term management plans):

  • Review medication plan with primary diagnosis, coordination of medication plan between primary care and behavioral health practitioners.

  • Review appropriate follow-up visits according to treatment plan, documentation and coordination of referral to internal and, external resources and transition plans in accordance with closure of the treatment plan.

  • Review case notes are timely and reflect adequate time to reach goals outlined in the plan of care and the level of care need.

  • Review the intake includes a thorough and accurate assessment for: suicide, homicide, abuse and appropriate legal reporting completion is documented.

  • Review  initial and follow-up appointments are appropriate to patients condition and treatment plan.

  • Performs concurrent review of mental health assessments, diagnosis, treatment and crisis intervention services for members.

  • Provides objective assessment of important aspects of patient care through ongoing chart review with pre-established criteria.

  • Collaborates with treating physician, psychiatric and allied health professional team to assess each individual members treatment program.

  • Collaborates with psychiatrists, allied health professionals, and other specialty care providers on psychological and neuropsychological plans of care.

  • Reviews members treatment and progress in accord with state and NCQA regulations and in keeping with accepted community standards.

  • Reports all occurrences which may lead to medical center liability and follows up as necessary.

  • Facilitates interdisciplinary collaboration for implementation of evidence based guidelines, criteria and other clinical tools to reduce variation in clinical practice and to optimize clinical outcomes.

  • Applies the appropriate performance improvement methodology to address improvement opportunity.

  • Educates physicians and staff regarding regulatory reviews, i.e. the interpretation of regulatory requirements and the methods of compliance when preparing for a review or the interpretation of project goals.

  • Supports the regional and medical centers continuous survey readiness program to maintain compliance with regulatory standards.

  • Conducts quality management studies through data collection, data input and report development and analyzes, interprets and provides recommendation based on quality principles.

  • Interprets regulations, health plan benefits, policies, and procedures for members, physicians, medical office staff, contract providers, and outside agencies.

  • Develops and maintains relationships and effective communication with all levels of medical center physicians and staff in order to facilitate problem identification and resolution.

  • Determines strategy for changing existing processes to meet regulatory requirements and translating external demands into program goals.

  • Design and develop reports; track all work via tracking logs or other databases.

Basic Qualifications:
Experience


  • Minimum three (3) years in assessing, diagnosing and treating a broad range of psychiatric conditions.

Education

  • Masters degree in Social Work or other Behavioral Health related field required from an accredited college or university required.
License, Certification, Registration
  • Registered Nurse License (California) OR Licensed Marriage and Family Therapist (California) OR Licensed Clinical Social Worker (California) OR Psychologist License (California)
Additional Requirements:

  • Knowledge of social service agencies, state regulations and APA standards as it related to client treatment, patient rights and client/patient confidentiality.
  • Previous clinical responsibilities to include behavioral health, diagnosis, crisis intervention, brief individual and group psychotherapy.
  • Knowledge of psychological testing techniques, administration and interpretation.
  • Excellent interpersonal and communication skills.
  • Demonstrated subject matter expertise in behavioral health care delivery.
  • Demonstrated ability to achieve results through influence and collaboration.
  • Demonstrated ability to conduct and interpret quantitative/qualitative information with analytical problem solving and project management.
  • Must demonstrate an understanding of any applicable regulations related to the responsible technical area.
  • Must be able to work in a Labor/Management Partnership environment.
Preferred Qualifications:

  • Mastery of computer software, Word, Excel, Access database, Powerpoint, etc.
  • PhD, PsyD, EdD, Nurse Psychiatric Practitioner or Psychiatric Clinical Specialist in clinical or counseling from an accredited college or university.
Primary Location: California,Pasadena,SCPMG Walnut Center Satellite Scheduled Weekly Hours: 40 Shift: Day Workdays: Mon, Tue, Wed, Thu, Fri Working Hours Start: 08:00 AM Working Hours End: 05:00 PM Job Schedule: Full-time Job Type: Standard Employee Status: Regular Employee Group/Union Affiliation: NUE-SCAL-01|NUE|Non Union Employee Job Level: Individual Contributor Department: Regional Offices - Pasadena - Rgnl Mg Admn-Behavioral Health - 0806 Pay Range: $99200 - $128370 Travel: Yes, 10 % of the Time At Kaiser Permanente, equity, inclusion and diversity are inextricably linked to our mission, and we aim to make it a part of everything we do. We know that having a diverse and inclusive workforce makes Kaiser Permanente a better place to receive health care, a more supportive partner in our communities we serve, and a more fulfilling place to work. Working at Kaiser Permanente means that you agree to and abide by our commitment to equity and our expectation that we all work together to create an inclusive work environment focused on a sense of belonging and wellbeing.

Kaiser Permanente is an equal opportunity employer committed to a diverse and inclusive workforce. Applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), age, sexual orientation, national origin, marital status, parental status, ancestry, disability, gender identity, veteran status, genetic information, other distinguishing characteristics of diversity and inclusion, or any other protected status.

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