Utilization Review Quality Improvement Specialist-26431407

County Of San Diego

San Diego, CA

JOB DETAILS
SALARY
$114,108.80–$140,275.20 Per Year
SKILLS
Acute Care, Adobe Acrobat, Analysis Skills, Auditing, Background Investigation, Behavioral Health, Clinical Assessment, Clinical Competency, Clinical Medicine, Clinical Psychology, Compensation and Benefits, Customer Support/Service, Data Analysis, Data Collection, Detail Oriented, Diversity, Documentation Standards, Federal Laws and Regulations, Government, Healthcare, Healthcare Administration, Healthcare Quality, Leadership, Legal, Licensed Clinical Social Worker (LCSW), Licensed Marriage and Family Therapist (LMFT), LinkedIn, Medi-Cal, Medical Records, Military, Network Programming, Organizational Skills, Outpatient Care, Patient Care, Performance Management, Policy Development, Problem Solving Skills, Procedure Development, Psychiatry and Mental Health, Quality Management, Registered Nurse (RN), Reporting Skills, Social Media, State Laws and Regulations, Strategic Planning, Sustainability, Translation Services, Utilization Management
LOCATION
San Diego, CA
POSTED
2 days ago

Utilization Review Quality Improvement Specialist-26431407

Salary

$114,108.80 - $140,275.20 Annually

Location

County of San Diego, CA

Job Type

Regular - Full time

Job Number

26431407

Department

Behavioral Health Services

Division

Behavioral Health Services

Opening Date

07/21/2026

Closing Date

8/3/2026 11:59 PM Pacific

  • Description
  • Benefits
  • Questions

Job Summary

Behavioral Health Services (BHS) is currently accepting applications for the position of

Utilization Review Quality Improvement Specialist

(RN, LCSW, LMFT, LPCC, Clinical Psych)

Interviews will take place the week of September 8, 2026.

Job offers for selected candidates will be made the week of September 14, 2026.

The starting salary for this position will be based on the candidate's qualifications at time of

appointment.

Future Salary Increases

June 2027 - 4.73% increase to base pay (3.0%

Across-the- Board +1.73% Market Adjustment)

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 in Behavioral Health Services Administration located at 3255 Camino del Rio South, San Diego; however, the list established from this recruitment may be used to fill future vacancies in other departments.

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

Read the Utilization Review Quality Improvement Specialist job description, including minimum qualifications and essential functions.

  • 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. *

Hiring Process and Timeline

  • Job Offer and Background Process begins after week of September 14, 2026.. Note: Current County employees may be excluded from additional background screening.
  • 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

Minimum Qualifications

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.

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.

Blind Applicant Screening

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. Current County employees may be excluded from this process.

Evaluation

The names of qualified applicants will be placed on a six (6) month employment list based upon scores received during the evaluation of information contained in their employment application and supplemental application questionnaire. Please ensure all information is complete and accurate, as the responses you provide on the supplemental application questionnaire will be reviewed using an automated evaluation system. If you are successful in the initial screening process, your application will be reviewed individually to confirm that the information you provided is accurate and qualifying.

Accommodation

Reasonable accommodation may be made to enable qualified individuals with disabilities to perform the essential functions of a job, on a case-by-case basis.

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. Please read the Veterans Preference Policy for additional information.

Military Skills Translator

Do you need assistance translating your military experience into civilian experience? This tool can help! Please read the Military Skills Translator to access the tool.

Disaster Service Worker

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).

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.

Click here to see the Non-Management Benefits Summary

01

Please be sure to answer the following questions in a thorough and complete manner, as your responses may be used to determine your overall score. Please note that if you are invited to a selection interview(s) by a department, your responses to the following questions may be subject to verification. Please do not respond to supplemental questions with "Refer to Resume." The experience indicated in your responses to the supplemental questions must also be described, in detail, on the Work History/Experience section of your Employment Application. Do you understand this information?

  • Yes
  • No

02

Indicate the current licensure by the State of California you possess.

  • Registered Nurse
  • Licensed Clinical Social Worker
  • Licensed Marriage Family Therapist
  • Licensed Clinical Psychologist
  • Licensed Professional Clinical Counselor
  • None of the above

03

Please provide your license number and expiration date.

04

Do you have 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 and Family Therapist, Licensed Clinical Psychologist, or related profession where duties included charting and interpreting medical records for the purpose of utilization review?

  • Yes
  • No

05

If you answered "Yes" to the previous question, please briefly describe your experience where duties included charting and interpreting medical records for the purpose of utilization review. Please provide the job title and the duties performed.

If you do not have any experience, please indicate "N/A." Note: The experience(s) listed below should be verifiable under the work history of the application.

06

Please indicate if you have experience with any of the following:

  • Quality Improvement Management
  • Performance Improvement Project
  • Utilization Review
  • Participation in a State/Federal Audit of a large organization
  • Medical Record Chart Review/Auditing
  • None of the Above

07

If you selected as having any experiences listed in the previous question, describe your experience for each item you selected. Be specific in how long the assignment, the setting, and your role. Indicate N/A if not applicable.

08

Are you familiar with medical records documentation standards including standards for clinical records; California and Federal regulations related to quality improvement and utilization review; and Medi-Cal review and audit process?

  • Yes
  • No

09

Do you have background in making accurate assessments of clinical diagnosis and treatment planning in various levels of care?

  • Yes
  • No

10

Please indicate if you have any experience in the following areas. Select all that apply.

  • Collecting/analyzing data and report writing
  • Writing Policies and Procedures
  • Writing clear/concise content for manuals
  • None of the above

11

Do you have any knowledge of specialty mental health managed care systems?

  • Yes
  • No

12

Do you have experience using an Electronic Health Record (EHR) for clinical documentation, treatment planning, and running reports?

  • Yes
  • No

13

Do you have experience in providing formal and informal staff training on any aspect of behavioral health service delivery, documenting to State and Federal regulations, training end users on use of EHR?

  • Yes
  • No

14

Please indicate any Quality Assurance/Quality Improvement certifications you may have. Select all that apply.

  • Health Care Quality and Management (HCQM)
  • Certified Professional in Healthcare Quality (CPHQ)
  • Other
  • None

15

For options selected in question #14 above, including "other", please indicate the current certificate/credential you possess.

16

Were you referred by a County employee to apply for this position? Note: effective September 9, 2022, County employees are eligible to earn cash awards for any candidates they refer to hard to recruit positions that are then hired.

  • Yes
  • No

17

If you responded "Yes" to the above, in the space provided please list the name of the County employee that referred you.

18

Where did you first hear about this job opportunity?

  • San Diego County website
  • Governmentjobs.com
  • Veteran Outreach / FFSC
  • Mana de San Diego
  • Family, Neighbors, Friends
  • County Employee Resources Group
  • College/University Career Site
  • County Social Media
  • LinkedIn
  • Indeed
  • Voice and Viewpoint
  • Government Alliance on Race and Equity
  • Job Fair/Career Event
  • Other

19

If you indicated "other" in question #18 above, please tell us how you first heard about this job opportunity in the space below. Please indicate N/A if not applicable.

Required Question

Employer County of San Diego

Address 5500 Overland Ave., Suite 370

San Diego, California, 92123

Phone (619) 236-2191

(866) 880-9374

Website http://www.SanDiegoCounty.gov

About the Company

C

County Of San Diego

We are committed to provide and retain a skilled, adaptable, and diverse workforce for County departments so they may deliver superior services to the residents and visitors of the County of San Diego.

COMPANY SIZE
10,000 employees or more
INDUSTRY
Government and Military
WEBSITE
https://www.sandiegocounty.gov/hr/