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Administrative Qualified Professional QP - CICS

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SouthLightRaleigh, NC
  • Administrative Qualified Professional (QP) - CICS
  • We are currently seeking a full-time Qualified Professional for our Community Intervention and Crisis Services (CICS) Program located on Garner Rd in Raleigh.
  • The primary role of the Administrative QP is to assure all areas related to service authorizations are completed and submitted per the expectations of the agency, MCO, and state service definitions.
  • Additionally, the Administrative QP will support utilization management and quality assurance initiatives for assigned programs.
  • Tap into your passion at SouthLight Healthcare.
  • Build your career in an environment where your voice, passion and work matters every day.
  • At the core of SouthLight is a commitment to our values, our employees and clients.
  • We strive to be an organization where every colleague can contribute and excel.
  • We are an equal opportunity employer and committed to building a culture that values diversity and inclusion.
  • SouthLight offers competitive opportunities and a robust benefits package.
  • About SouthLight Healthcare
  • Founded in 1970, SouthLight Healthcare is one of the area's largest and long-established nonprofit providers of substance use treatment and mental health services.
  • With outpatient and community-based programs, SouthLight provides prevention, education and treatment services in the Triangle and beyond.
  • SouthLight has multiple office locations throughout the Triangle area, serving more than 9,000 clients each year.
  • Services include adult outpatient counseling, Intensive Outpatient Program, Psychiatric Services and Medication Management, Opioid Treatment Program, Court Deferral Program, Peer Support Services, Family Centered Treatment, Community Support Team and a residential treatment program for women and children and more.
  • Function as the office based/remote QP as necessary according to service definition requirements
  • Fluent and knowledgeable of service definitions with a focus on MAT/OTP, OBOT, SAIOP and SACOT
  • Coordinate with staff members for the collection of all relevant/required documents and information needed to compose Service Authorization Request justifications
  • Audit authorization documents for accuracy, ensuring criteria for service being requested has been met (ASAM, LOCUS, signatures etc.)
  • Submit authorizations within required timeframes
  • Support program managers and staff in monitoring authorization due dates and required timeframes
  • Assist Leads/Managers in obtaining and disseminating reports related to billing, NC TOPPS, and authorization related information.
  • Maintain necessary charts/information relevant to authorizations, referrals, discharges for multiple teams
  • Establish/maintain relationships with a comprehensive, targeted listed of providers and other relevant community organizations
  • Ensure compliance for NC TOPPS submissions and updates by supporting staff through monitoring and accountability
  • Coordinate with staff members when Funding Source require additional information for Authorization approvals
  • Maintain Electronic Health Record Client Data for completeness and accuracy with the use of system generated reports
  • Provide general quality assurance oversite as needed including but not limited to: EHR, NCTOPPs, SARs, etc.
  • Educational and Experience
  • Minimum of Bachelor's Degree in human services field
  • Two years' experience working with the population (directly or indirectly)
  • Two years' experience working in community mental health setting preferred
  • QP status required with MH/SA population
  • Knowledge, Skills and Abilities Required
  • Microsoft Office Suite
  • Experience with software applications (EHRs, Alpha MCS, etc.)
  • Excellent organizational skills and attention to detail
  • Ability to multi-task, prioritize and meet deadlines
  • Ability to communicate effectively with a wide variety of people
  • Maintain flexible and coachable demeanor
  • Ability to work within a team
  • Comfortable working independently from remote location and/or office based
  • Excellent written/ documentation skills.
  • Full-time employees are eligible for medical benefits the first of the month 30 days after hire date.
  • Options for a standard plan and an HSA plan with a $300 initial contribution and up to a $25 per paycheck match.
  • 10 paid holidays and PTO hours which accrue at a rate of 10 hours per month.
  • After 6 months employees are eligible to enroll in our 401(k) plan which has a 4% match.
  • Company paid life insurance, short and long term disability, in house and paid training opportunities, and additional pay for working holidays.
  • You may apply at our website: & click "View Current Openings" You can also sign up for job alerts!
  • Employment History Company Name, Phone Number, Supervisor's Name, Dates of Employment, List of Duties
  • Education Institution Name, Address, Degree Earned, Years Attended, Major of Study
  • Resume We prefer an uploaded file.
  • You may also cut and paste a text version in the space provided, however text resumes are often more difficult to read.
  • Please only use DOC, DOCX, TXT or PDF files 10 MB or smaller when uploading files.
  • Professional References Three Required Names, Relationship, Company, Title, Phone Number, Email, Years Known
  • Background Information Explanation of any convictions, if applicable
  • SouthLight Healthcare is an Equal Opportunity Employer -
  • We agree not to discriminate against any employee or job applicant because of race, color, religion, national origin, sex
  • SouthLight is committed to keeping our clients and employees safe and healthy.
  • We are following guidance for healthcare providers and requiring the COVID-19 vaccination for all new hires.

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