This position is responsible for the development of a clinical quality oversight department. Day to day responsibilities include field oversight of the Clinical Auditors and Clinical Coaches. The focus of this role is on the day to day delivery of excellence in the quality of medical records documented during the home assessment visit. This position is a key leadership position in the organization that reports directly to the AVP, House Call Operations.
- Develop and coach clinical auditing staff in appropriate audit and trending techniques to be used in the completion of audits of the organization’s medical documentation in accordance with the organization’s documentation standards.
- Develop and coach clinical coaching staff in appropriate methods of communication of documentation issues and remediation efforts required to meet/exceed the organization’s documentation standards.
- Measure and monitor skill levels of staff, assign duties and delegate responsibilities as appropriate, complete performance evaluations, track productivity and attendance
- Develop/continually improve the audit protocols based on audit findings; this includes but is not limited to documenting the audit process; establishing performance thresholds; developing and updating tools and score cards.
- Demonstrates knowledge of compliance with policies, contracts and accreditation bodies
- Assist with urgent and complex cases that require management level support to staff
- Responsible for approval of timesheets including PTO and expenses
- Train and educate staff on Continuous Quality Improvement (CQI) initiatives, new and updated clinical policies, departmental workflow and protocols
- Perform special projects and assignments as directed by management
- Participates in special projects
- Maintains a motivated and productive staff by providing sound leadership and direction. Models appropriate behaviors, render timely decisions, and provide coaching, feedback and recognition. Conducts timely and appropriate performance appraisals. Selects the best qualified candidates to fill job vacancies, administers company policies fairly, and provides for development activities and opportunities to assure application and assessment skills are learned.
- The supervisor complies with the laws, regulations, and takes reasonable steps to ensure that staff members know and understand laws, regulations, and policies that pertain to the organizational unit’s business and takes reasonable steps to assure staff conform their actions accordingly.
Knowledge, Skills and Abilities:
- Knowledge of basic Medicare and Medicaid rules and regulations
- Coding knowledge (CPC preferred, but not required)
- Knowledge of personal computers and software
- Knowledge of quality audit practices and protocols
- Requires excellent written and verbal communication skills
- Requires good organizational and strong analytical skills
- Knowledge of medical records documentation standards to support billing and coding activities
- Current RN license
- Minimum of two years of experience in quality auditing within a healthcare organization.
- Minimum of three years’ experience in nursing management
- Intermediate skill levels of Microsoft Word, Excel and Outlook preferred
Job ID 2017-1775