Utilization Review Quality Improvement Specialist Job at County of San Diego

County of San Diego San Diego, CA

The Health and Human Services Agency's Behavioral Health Services
is currently accepting applications for the position of

Utilization Review Quality Improvement Specialist
(RN, LCSW, MFT, LPCC, Clinical Psych.)

Future Salary Increases


** July 2023 - 7.83% increase to base pay (2.75% Across-the-Board + 5.08% Market Increase)
** July 2024 - 7.83% increase to base pay (2.75% Across-the-Board + 5.08% Market Increase)

Utilization Review Quality Improvement Specialists chart and interpret medical records for utilization review and reviews medical records for medical necessity and Medi-Cal compliance in County operated inpatient, outpatient, day treatment, and contracted facilities. The current vacancy is located at Behavioral Health Services, 3255 Camino del Rio South, San Diego.

The Utilization Review Quality Improvement Specialist position has two options where focus is on either the quality management of mental health programs OR substance use disorders (SUD) programs.

***Effective September 9, 2022, this hard to recruit position qualifies for the Employee Referral Reward Program. If a current County of San Diego employee referred you to apply for this position, please indicate the employee’s name on your job application in the space provided. ***

Interviews and Hiring Process


Job offers for selected candidates will be made shortly after the interviews. Candidates should be prepared to immediately complete background paperwork, upon receipt of a job offer.

The timeline for this recruitment is outlined below. Please note that dates are approximate and are dependent upon the successful completion of each step of the process.
  • Job Offer and Background Process begins: Shortly after the interviews.
  • Pre-employment Medical Screening: Approximately 3 days following successful background investigation results.
  • Anticipated Start Date: Start date will be based upon successful completion of medical screening or other mutually agreed upon date.
If you are not selected for this interview process, you may have the opportunity to compete for future vacancies.

Required Education and Experience:
  • Current valid California license as a Registered Nurse, Licensed Clinical Social Worker, Licensed Marriage Family Therapist, Licensed Professional Clinical Counselor, or Licensed Clinical Psychologist is required at time of application and must be maintained throughout employment; AND,
  • One (1) year of recent, licensed clinical experience in an acute care psychiatric hospital or outpatient facility performing the duties of a Registered Nurse, Licensed Clinical Social Worker, Licensed Marriage Family Therapist, Licensed Professional Clinical Counselor, Licensed Clinical Psychologist, or related profession where duties included charting and interpreting medical records for the purpose of utilization review.

Note: Quality improvement, utilization review, peer review, or other chart review experience is highly desirable.

Click here for a complete Utilization Review Quality Improvement Specialist job description, including minimum qualifications and essential functions.

The Department of Human Resources removes personally identifiable information from all recruitments. This practice, called Blind Applicant Screening, hides a candidate’s personal information that could influence or bias a hiring decision. Personal information includes name, phone number, address, gender, age and race. This process helps contribute to a fair and equitable selection process leading to a more diverse and inclusive workforce.

The most highly qualified candidates, based on the evaluation results, will be referred for an interview. Be sure to include your experience in meeting the minimum requirements in both the Work Experience section and the Supplemental Questionnaire section of the Application.

Resumes will not be accepted in lieu of the application Work History and/or supplemental questionnaire.

Condition of Employment

As part of the County of San Diego’s pre-employment process, prospective candidates will undergo a background check (including fingerprinting) and a pre-employment medical screening prior to beginning County employment. Additional types of background investigations may be conducted based on the job-related activities of the position.

Employees who work at County locations subject to the California Department of Public Health State Public Health Officer order are required to be fully vaccinated. In addition, booster-eligible employees must receive their booster by March 1, 2022, or within 15 days of becoming eligible for a booster if they are not eligible as of March 1, 2022. If there are CDPH date changes for Booster compliance, employees must come into compliance in accordance with that date.

If unvaccinated or not fully vaccinated (including booster), employees in some locations covered by the Public Health Officer Orders who remain in the workplace may be eligible for an accommodation.
Career Paths
Employment with the County of San Diego is more than a job, it's a career! Career Paths are terrific and valuable tools to help plan your career with the County. The County of San Diego offers employees many different ways to promote and develop within the organization. Click here to check it out for yourself! The career path for the Utilization Review Quality Improvement Specialists can be located under Behavioral Health or Nursing from the Career Paths page.

The ideal candidate will:
  • Have knowledge and experience in electronic health records and training
  • Possess strong clinical and analytical skills, be detail oriented, and have excellent customer service skills
  • Work well independently and within a team, and speak in front of groups
  • Have the ability to analyze complex information and problems, and the ability to apply critical thinking to solve complex problems.
  • Have knowledge of federal and state regulations regarding the delivery of mental health, and alcohol and drug services to the County of San Diego Behavioral Health System of Care.
  • Have knowledge of quality improvement practices in order to implement quality improvement processes; ability to understand and interpret policies and procedures.
  • Be well organized and adaptive to fluctuating workload assignments and a positive attitude in their work style in order to accomplish the goals of the Quality Improvement Unit.
  • Have knowledge of the MHMIS/Anasazi/Cerner Community Behavioral Health (CCBH) Electronic Health Record.

Desirable Traits:

Communicates Effectively, Knowledge Worker, Customer Focused, Values and Respects Others, Drives to Excel, Teamwork and Collaboration, Continuous Learning, Demonstrates Ethical Behavior, Supportive of Change

Evaluation:

The names of qualified applicants will be placed on a six (6) month employment list based on information provided on the employment application and supplemental questionnaire.

Note: Reasonable accommodation may be made to enable a qualified individual with a disability to perform the essential functions of a job, on a case-by-case basis.

The County of San Diego and its employees embrace the vision of: a just, sustainable, and resilient future for all. Our values include: integrity, equity, access, belonging, excellence, and sustainability. Each of which are infused throughout our operations. While also embracing a mission of strengthening our communities with innovative, inclusive, and data driven services through a skilled and supported workforce. Click here for more information on our Strategic Plan (sandiegocounty.gov) (Download PDF reader) as well as our commitment to serve everyone, to build a Framework for the Future that will create a County that works for all.
As an employer of over 19,000 employees, the County of San Diego is an organization committed to veteran hiring, retention, and professional development. We recognize the contributions and sacrifices made by our veterans and value the unique expertise and leadership qualities they bring to our workforce. We strive to provide veterans with the resources and tools necessary to maximize their employment opportunities, and to assist veterans with their transition into civilian life by applying the valuable skills, knowledge and training acquired in service to positions and career paths at all levels within our large organization. Click on the resource links below to learn more about how the County of San Diego supports its veterans.

Veteran’s Preference Policy The County of San Diego offers preferential credits for military service to assist qualified applicants in transitioning from military to civilian careers with the County of San Diego.

Military Skills Translator Do you need assistance translating your military experience into civilian experience? This tool can help!
Under California Government Code Sections 3100 - 3109, public employees are designated as disaster service workers. The term "public employees" includes all persons employed by the state or any county, city, state agency, or public district. Disaster service workers are required to participate in such disaster service activities as may be assigned to them by their employer or by law.

The County of San Diego is committed to valuing diversity and practicing inclusion because our diverse workforce is our greatest asset and our customers are our number one priority.




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