Coordinate communication between team members/attending physicians/caregivers to ensure the appropriateness of care and outcome planning and ensures compliance through review of documentation and care coordination activities.
Manage secondary operations and work closely with manufacturing to determine and offer guidance to related areas; direct and supervise quality staff, interpret customer requirements and provide technical assistance to team.
In this role, you will be responsible for the maintenance of clinical records and files to comply with Conditions of Participation (COPs), using measurements, as licensure, certification, and accreditation results.
Review all Medicare and other episodic payers clinical records at the local level to assure appropriate documentation for reimbursement. This review includes verification of appropriate documentation, quality of care provided, visits utilization, appropriate contacts with physicians, adherence to the care plan, and evidence of communication between disciplines.
The incumbent will be responsible for the Retail Lending Operations Quality Assurance function (QA) within U.S. Independent Controls (IC), which covers Retail Lending Originations and Retail/Small Business Lending Servicing.
The incumbent works closely with R&D regarding product quality planning and design change/improvements that will have significant impact on the business. The incumbent maintains communication with the Director-QRA for assistance in resolving major quality initiatives/projects and executing design, development, and design transfer initiatives