Greater Oregon Behavioral Health, Inc. (GOBHI) has an immediate opening for a Behavioral Health Clinical Auditor. This key position will be based out of the employee’s home office, which will need to be located within the state of Oregon or accepted radius.

The Behavioral Health Clinical Auditor is responsible to ensure compliance with organizational contracts. Provide monitoring of network provider payment integrity, efficiency, and compliance with organizational contracts. This position also provides project management support in key behavioral health initiatives.

Essential duties include:

• Complete subcontractor or provider audits both on-site and desk;
• Development and implementation of an annual plan to audit providers that enables GOBHI/EOCCO to validate the accuracy of encounter data against provider charts;
• Lead the selection of providers who are identified as high risk for purposes of auditing;
• Maintain records of GOBHI/EOCCO actions related to overpayments and claims invalidation;
• Routine internal monitoring, reporting, and auditing of fraud, waste and abuse risks and other related compliance risks;
• Lead develop and monitor corrective action plans;
• Conduct verification of service calls as scheduled;
• Project management for key behavioral health initiatives as assigned;
• Drives to meetings or other GOBHI locations as needed;
• Performs other related duties as assigned.

What is needed to succeed in this role:

• Three years’ experience in health care which have included activities related to assessments, service plans and service notes; or, any combination of education and experience.
• Two years’ experience in auditing and monitoring or certification in healthcare compliance preferred.
• Ability to communicate effectively at multiple levels.
• Strong planning and organizational skills.
• Technology savy – comfortable using MS and Google Suite software products. High level of proficiency in Excel or Google sheets.
• Maintains good driving record and required vehicle insurance.
• Education – Master’s degree in Behavioral Health or related field required with behavioral health licensure preferred.
• Bilingual in Spanish preferred.

What we offer:

• Competitive salary
• Additional compensation for proven bilingual skills
• Medical, dental and vision insurance for you and dependents
• Generous paid time off
• Company paid life, short-term disability, and long-term disability insurances
• EAP
• FSA, with a $500 employer contribution
• Triple AAA insurance
• Mileage reimbursement
• Wellness benefits
• 401k contribution, including 6.5% employer contributions
• Cell phone and internet reimbursements

About GOBHI:

Founded in 1994, Greater Oregon Behavioral Health, Inc. is an innovative behavioral health organization that serves communities across Oregon. GOBHI is a 501(c)(3) nonprofit corporation that is charged with administering the behavioral health Medicaid benefit, non-emergent medical transportation and community engagement in 12 rural and frontier counties in Oregon.

GOBHI is a co-owner of the Eastern Oregon Coordinated Care Organization, along with Moda Health, and also provides various direct services statewide. GOBHI is committed to better health, better care, and lower costs. Please visit www.gobhi.org to learn more about our mission and services.