In this role, you will be responsible for all activities involving quality assurance and compliance with applicable regulatory requirements; conducts audits and reviews/analyzes data and documentation. Familiar with a variety of the field's concepts, practices, and procedures.
In this role, you will be responsible for the personnel functions of the Quality Associate(s); including direction, assignment of work, hiring, development and training, disciplinary actions, termination, maintenance of all personnel records, management of work schedule and delegation / follow - up of tasks.
In this role, you will lead quality assurance reviews assessing network and system security controls design, review, and consultation in all areas of the organization. Conduct security risk assessments and reporting results, including recommendations for corrective actions.
In this role, the selected candidate will coordinates performance improvement, and the development of quality initiatives required for cancer center accreditations; identify and develop processes to improve outcomes across the continuum of care.
In this role, the selected candidate will monitor expenses incurred and travel, both completed and scheduled, to ensure the departmental objectives are being met both based upon monthly and yearly goals.
In this role, the selected candidate will support initial and on-going compliance with state and federal quality improvement requirements; specifically from Chapter 5 of the Medicare Managed Care Manual, internal and new client health plans.
In this role, you will be responsible for
analyzing and providing product quality information to facilitate the identification and investigation of quality issues and/or trends and drive corrective action.
In this role, you will analyze, develop, and implement changes to existing and new Pay for Performance, Value Based Purchasing, Transitional Case Management, Meaningful Use, Patient Centered Medical Home, Physician Quality Reporting System, and Medicare-based Incentive Programs.
In this role, the selected candidate will ensure service quality and participates in care coordination to ensure proper communication between caregivers, patients, referral sources and payers; discuss operational issues, update staff on new/changed regulations and review records/documentation to ensure regulatory and in-house compliance.