We are seeking an experienced and detail-oriented Psychiatric Mental Health Nurse Practitioner (PMHNP) to join our team in a specialized role focused on clinical quality assurance, compliance oversight, and medical record auditing.
This position is ideal for a provider with strong psychiatric clinical experience who has a deep understanding of documentation standards, regulatory compliance, and quality control processes within behavioral health and long-term care settings.
Compliance & Regulatory Knowledge Required
- · Centers for Medicare & Medicaid Services (CMS) Guidelines
- · CMS Psychotropic Medication Guidelines
- · Medicare Documentation Standards
- · Federal Healthcare Compliance Regulations
- · State Nursing Board Regulations
- HIPAA (Health Insurance Portability and Accountability Act)
The PMHNP will play a critical role in reviewing clinical documentation, ensuring compliance with payer requirements, auditing patient records for accuracy and completeness, and supporting overall clinical quality initiatives.
Primary Responsibilities
- Conduct comprehensive audits of psychiatric medical records for accuracy, completeness, and compliance.
- Review documentation to ensure proper coding, billing support, and adherence to payer requirements.
- Audit provider notes for clinical appropriateness, treatment plan accuracy, and documentation integrity.
- Review records to ensure compliance with Centers for Medicare & Medicaid Services (CMS) guidelines, Medicaid, Medicare, and commercial insurance requirements.
- Evaluate psychiatric assessments, follow-up visits, medication management documentation, and treatment plans.
- Identify documentation deficiencies and communicate corrective action recommendations.
- Assist in maintaining internal quality assurance standards across providers and facilities.
- Review provider compliance with state and federal regulations governing psychiatric care.
- Support ongoing clinical improvement initiatives through trend analysis and audit reporting.
- Work collaboratively with operations, billing, compliance, and provider leadership teams.
- Participate in provider education regarding documentation standards and best practices.
- Assist in developing internal audit processes and quality control protocols.
Qualifications
Required:
- Active and unrestricted Psychiatric Mental Health Nurse Practitioner (PMHNP) license.
- Board Certification as a PMHNP.
- Minimum 3+ years clinical psychiatric practice experience.
- Must have CMS guidelines experience/knowledge
- Strong knowledge of psychiatric evaluation and medication management documentation.
- Experience reviewing psychiatric medical records and clinical documentation.
- Understanding of behavioral health billing requirements and payer documentation standards.
- Knowledge of Medicare, Medicaid, and insurance compliance guidelines.
- Strong attention to detail and ability to identify documentation inconsistencies.
- Excellent written and verbal communication skills.
Preferred:
- Experience in long-term care, skilled nursing facilities, or geriatric psychiatry.
- Experience with medical record auditing or utilization review.
- Familiarity with EHR systems such as eClinicalWorks or other electronic medical record platforms.
- Experience working with compliance programs and quality assurance initiatives.
Skills & Competencies
- Clinical Documentation Review
- Quality Assurance & Compliance Auditing
- Medical Record Auditing
- Behavioral Health Documentation Standards
- Medicare & Medicaid Compliance
- Risk Management
- Provider Education & Feedback
- Attention to Detail
- Clinical Process Improvement
- Regulatory Compliance
Why Join Us
This role offers an opportunity to directly impact the quality of psychiatric care delivery by ensuring providers maintain the highest standards of clinical documentation, compliance, and patient care excellence.
You will help strengthen clinical integrity while supporting operational excellence across a growing behavioral health organization.
Job Type: Part-time
Pay: $60.00 - $65.00 per hour
Application Question(s):
- Do you have Medicare CMS guidelines knowledge or experience
- Are you comfortable with providing training via a virtual experience?
Experience:
- CMS Medicare Guidelines: 1 year (Required)
Work Location: Hybrid remote in Atlanta, GA 30328
