Quality Management Clinical Analyst - Staten Island, United States - Centers Plan for Healthy Living

Centers Plan for Healthy Living
Centers Plan for Healthy Living
Verified Company
Staten Island, United States

3 weeks ago

Mark Lane

Posted by:

Mark Lane

beBee recruiter
Description

Responsibilities:


  • Incident reporting: logging, investigation, ensures written report on file, assists clinical managers with written reports, collates information on a quarterly basis. Provides education to clinical staff regarding risk management and incident reporting.
  • Medicare expedited appeals. Review case, writes detailed notice, ensures all information is sent to the QIO.
  • Conducts quarterly utilization review including the preparation of the UR report for UR Committee and Professional Advisory Committee (PAC) presentation.
  • Infection reporting and infection control: Investigation, record review, writing infection reports, collating and reporting data to PAC.
  • Medical record requests: oversight of QM Assistant with processing medical record requests to ensure timely distribution, audit of the record prior to distribution to the requestor.
  • Potentially Avoidable Events (PAE): review OASIS PAE reports and conducts record audit of patient experiencing potentially avoidable events to determine agency risk in the event occurrence; prepares PAE report for PAC presentation. Provides feedback to clinical management on deficiencies found.
  • Focused record audits related to problem prone areas, performance improvement projects and plans of correction on an as needed basis. Provides feedback to clinical management on deficiencies.
  • Assists QM Director/Compliance Officer with complaint and other investigations as requested including review of patient record.
  • Vendor Management: conducts personnel file audits and policy review of new vendors to ensure that vendor meet Agency standards.
Job Qualifications Required

  • At least 2 years' CHHA experience preferably in a quality assurance role.
Education, Knowledge, Skills and Abilities Preferred

  • RN, BSN preferred.
  • Word, Excel, Power Point

Job Type:
Full-time
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