ColoradoSpringsRecruiter Since 2001
the smart solution for Colorado Springs jobs


Company: Beacon Health Options
Location: Colorado Springs
Posted on: September 13, 2020

Job Description:

We Help People Live their Lives to the Fullest Potential!

For more than 30 years, Beacon has changed the way people live with behavioral health conditions. Today, we are the undisputed leader in behavioral health management, serving 40 million people across all 50 states. At Beacon, we are committed to delivering a'world-class' candidate experience from the moment you click'Apply'! Our goal is to help you reach your fullest potential, while utilizing your talents and expertise to help us deliver on our promise.

Do you have a passion for helping others? If so, we are looking for you!

Beacon is currently seeking a Clinical Quality Specialist III to join our team out of Colorado Springs, CO. The Clinical Quality Specialist III is a professional level position that supports clinical quality management functions and implements contractual requirements such as auditing and practice transformation. This position will participate in a range of quality management activities, including planning, implementation, monitoring, training, and reporting. This position is responsible for providing leadership and coordination of clinical, quality and provider-related quality activities, including provider record review process, performance/quality improvement projects including practice transformation program, quality of care issues and the provider monitoring program. Extensive in-state travel up to 30% with overnight stays is required.

What does a typical day look like?

  • Conduct contract-required quality reviews to ensure compliance with policies, state and federal standards and client performance standards and participate in other monitoring assignments as required (i.e. practice transformation, APM measure audits).
  • Work with Clinical, Provider Relations and QM Departments to establish and maintain processes for regular treatment record reviews (mental health, substance use, hospital, residential, care coordination and others as assigned).
  • Conduct contractual audits (Care Coordination, Practice Transformation), treatment record audits; and compile and report results. Audits may occur at provider offices or facilities or virtually.
  • Identify trends and patterns of deficiencies within practices, evaluate results, identify and communicate areas for improvement
  • Coordinate and communicate provider monitoring and improvement activities and results. Provide feedback letters, initiate corrective actions and monitor as specified in policy.
  • Identify specific areas of focus for treatment record audits and provider training/education annually; evaluate results, identify, and communicate areas for improvement within the system. Coordinate the claims recoupment process for behavioral health and substance use services as assigned, based on audit results and policy guidelines.
  • Coordinate and communicate provider monitoring, improvement and education activities and results within the QM Department, inter-departmentally, and externally; distribute/communicate to client and provider organizations as specified. Monitor corrective action plans for improvement. Participate in provider monitoring formal feedback efforts. Initiate and/or plan and participate in the annual contract compliance audits/site visits as directed.
  • Conduct and track adverse incident and quality of care issue investigations as needed; attend associated meetings and training.
  • Co-chair or lead assigned meetings; participate in State, client and provider/facility meetings and performance improvement and practice transformation initiatives (PIPs, behavioral health, KPI measures) as directed.
  • Work with Quality Manager to coordinate the annual encounter/claims audit.
  • Conduct other routine QM Department tasks, including ensuring assigned areas of responsibility comply with contract, and State requirements; preparation of documents for External Quality Review, delegation or other site visits.

    What you Contribute?

    Education: RN (preferred) Master's degree in clinical specialty; substance use treatment experience preferred.

    License: Licensure is preferred: RN, LCSW, LPC, LMFT, or PhD are acceptable

    Knowledge, Skills& Abilities: Two years of direct treatment experience is required and at least one year experience in Quality Management, auditing, or managed care; behavioral health background/licensure or RN preferred.

    What Makes Us Different?

    • Here, it's not just a job- it's an opportunity to change lives.
    • Our employees are learners, innovators and original thinkers.
    • Our mission and values guide the way we treat our members, providers and each other.

      What We Have to Offer:

      • Healthcare benefits available starting day 1!
      • Health& wellbeing incentives, such as gym membership reimbursement
      • 401K with company match to help reach your future financial goals
      • Generous PTO, because we know life happens outside of work

        If Beacon sounds like the place for you, what are you waiting for? Apply with us today to get started!

        Click below on"Apply for this Position" to create a profile and apply for the position

        Beacon Health Options company, is proud to be an Equal Opportunity and Affirmative Action Employer as well as a Drug Free and Tobacco Free Work Environment. EOE/AA/M/F/Veterans/Disabled

        At Beacon Health Options, our candidate's data privacy is a top priority. Our recruiting team conducts all communications using official company email ( Only candidates who have applied for an open position through our Careers page ( will be engaged in our interview process. Beacon conducts all interviews in person or over the phone. At no time during the recruiting process will any Beacon recruiter request any financial or personally identifiable information from you.




Keywords: Beacon Health Options, Colorado Springs , QUALITY MANAGEMENT III, Executive , Colorado Springs, Colorado

Click here to apply!

Didn't find what you're looking for? Search again!

I'm looking for
in category

Other Executive Jobs

Insurance Account Manager
Description: We are an independent insurance agency seeking an experienced commercial lines account manager to join our team. We offer an excellent salary, generous vacation time, flexible hours and other benefits. (more...)
Company: LF Insurance Group
Location: Golden
Posted on: 09/27/2020

Director, Community Relations and Public Policy
Description: EMPLOYMENT VALUE PROPOSITION: Mental Health Center of Denver provides you with the support you need to help you develop a career in helping others succeed. We innovate, adapt, and leverage the diverse (more...)
Company: Mental Health Center of Denver
Location: Denver
Posted on: 09/27/2020

Assistant Director of EVS - Denver, CO
Description: If you are passionate about making a difference and impacting patient care, we'd like you to join our team We are looking for a driven individual to serve as the Assistant Director of Environmental Services. (more...)
Company: Hospital Housekeeping Systems LLC
Location: Englewood
Posted on: 09/27/2020

Psychiatry in CO - Medical Director Needed in Denver, CO
Description: Medical Director opening in Denver, Colorado. This and other physician jobs brought to you by CompHealth is currently assisting a Denver, Colorado program with their search for a medical director (more...)
Company: CompHealth
Location: Denver
Posted on: 09/27/2020

Sr. Manager Systems Engineering - Chief Architect
Description: The Chief Architect CA contributes to a team of systems engineers in accomplishment of system and segment engineering tasks in an iterative development environment. The CA provides technical direction (more...)
Company: RTX
Location: Watkins
Posted on: 09/27/2020

Travel Nurse RN - Case Management - $1,681 per week
Description: TaleMed is seeking a travel nurse RN Case Management for a travel nursing job in Denver, Colorado.Job Description Requirements ul li Specialty: Case Management li Discipline: RN li Start Date: (more...)
Company: NurseFly Travel Nursing
Location: Denver
Posted on: 09/27/2020

Training Account Manager
Description: JOB DESCRIPTION: br br Cloudera is the Enterprise Data Cloud Company. Our technology allows customers to unlock the power of any data, running in any cloud, from the Edge to AI, on a 100-percent open-source (more...)
Company: Cloudera, Inc.
Location: Denver
Posted on: 09/27/2020

Senior Director, US Marketing
Description: About us MessageMedia provides innovative mobile messaging solutions that help businesses of all sizes - from SMBs to enterprise-level - better connect with customers. With 90 percent of messages read (more...)
Company: MessageMedia
Location: Denver
Posted on: 09/27/2020

Director, Checking Product Management
Description: Purpose of Job 10 10 We are currently seeking a talented Director, Checking Product Management for one of the following locations: San Antonio Home Office II/III, Phoenix Campus, Colorado Springs Campus, (more...)
Company: USAA
Location: Monument
Posted on: 09/27/2020

Team Director
Description: In a hard-working, fun-filled office environment, our Team Directors function as nurse managers, partnering with our clinical support leadership team to supervise the day-to-day operations of interdisciplinary (more...)
Company: Seasons Hospice & Palliative Care
Location: Westminster
Posted on: 09/27/2020

Log In or Create An Account

Get the latest Colorado jobs by following @recnetCO on Twitter!

Colorado Springs RSS job feeds