RN Quality Assurance Auditor

Geode Health

$85K — $100K *
US-AnywhereRemote in United States
Healthcare
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • Bachelor's degree in business administration, science, healthcare, public health, or related life sciences field
  • Registered Nurse (RN) license required
  • Three years of quality assurance experience, preferably in Behavioral/Mental Health
  • Proficient in managing detailed, sensitive information
  • High level of discretion and confidentiality
  • Ability to learn complex processes and medical terminology
  • Strong prioritization and multitasking skills
  • Ability to work independently

Responsibilities

  • Conduct audits according to schedule and established procedures
  • Audit patient records for accuracy and completeness
  • Prepare records for audits conducted by other staff
  • Identify improvements in record quality and process efficiency
  • Maintain auditing data for analysis and tracking
  • Educate staff on audit findings and recommendations
  • Develop policies and workflows for auditing processes
  • Analyze auditing data to generate metrics
  • Prepare and present audits and analytics to leadership

Benefits

  • Remote work flexibility
  • Annual bonus incentive
  • Professional development opportunities
  • Supportive work environment for maintaining discretion and integrity
  • Exposure to behavioral health practices and quality improvement initiatives
Full Job Description
Comp Range: $85k - 100k/year + 10% annual bonus.

Job Responsibilities

Quality Assurance Audits
  • Complete audits according to an established audit schedule and audit procedures.
  • Audit patient records for completeness, accuracy, and appropriateness. The audits may include but not be limited to ensuring records include the minimal required data, comparing source data to the records for accuracy, and analyzing select data in detail.
  • Audit patient records and processes related to Geode's QI/QA program.
  • Prepare records for audits that are performed by other staff including but not limited to medical director chart reviews, patient reviews, imminent and eligible classification reviews, and Geode Health internal audits.
  • Identify opportunities to improve the quality of records, efficiency of processes, and increase performance.
  • Maintain detailed auditing data including workload details and documented audit findings, recommendations, and corrections in a manner that will allow this data to be categorized, tracked, and trended for analytics.
  • Inform and educate staff of audit findings, recommendations, and corrections.
  • Report audit findings, recommendations, and corrections to internal leadership. Complete follow up activities as directed.
  • Monitor and follow up on requested audit corrections to ensure they have been completed.
  • Develop audit and documentation/recordkeeping policies, procedures, and workflows.
  • Organize root cause analyses (RCAs), take minutes, and implement action items from RCAs.

Quality Assurance Analytics
  • Establish auditing goals, expectations, and benchmarks and ensure these are met or exceeded.
  • Create and/or adopt existing tools, systems, and methods to organize and catalog a variety of auditing data.
  • Perform analysis on auditing data to generate metrics and other tracking and trending analytics.
  • Interpret and monitor metrics and analytics to identify meaning, trends, and compliance towards auditing goals, expectations, and benchmarks.
  • Prepare and present analytics to internal leadership, as well as external audiences ranging from front-end staff to executive leaders.

Qualifications
  • Bachelor's degree in business administration, science, health care, public health, or other life sciences related field
  • Registered Nurse (RN) license required
  • Three year of related quality assurance experience; within Behavioral / Mental Health preferred
  • Ability to work with highly detailed, complex and emotionally sensitive information.
  • Ability to maintain a high degree of discretion, confidentiality, protection, and integrity.
  • Ability to learn complex processes, medical terminology, technology systems, and progressively develop data analytics skill set.
  • Ability to prioritize and complete multiple complex work assignments.
  • Ability to work independently.
  • Knowledge of quality assurance, quality systems, internal auditing, and/or quality improvement preferred.

#LI-Remote

Estimated earnings:
$80,000.00-$100,000.00

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