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Details
Posted: 02-Sep-23
Location: Irving, Texas
Salary: Open
Categories:
Quality/Risk Management
Internal Number: 15670900
Summary:
This position performs audit functions for the Quality Management team and delegated vendors and partners to determine operational efficiency, adherence to regulatory requirements and achievement of quality standards.
- The Senior Quality Clinical Auditor will conduct, review, analyze and summarize findings of audit plans for internal business units and delegated partners and entities on a monthly, quarterly and/or annual basis
- Focuses specifically on Patient safety and Quality of Care audits and initiatives, supporting documentations and authorization to ensure compliance with regulation, policy and procedures for multiple lines of business
- Must be able to effectively collect, aggregate, sort and communicate summary of data collected (ex: by utilizing excel pivot tables, charts and graphs to share findings and prepare materials for reporting purposes
- Collaborate with Risk Management and Director of Quality to develop and maintain a comprehensive CHRISTUS patient safety plan; thereby, ensuring the appropriate data collection and management system are produced to create data reports, analysis, and reporting of trends to CHRISTUS patient safety committee and other committees as needed
- Identify opportunities for improvement, problem prioritization and creating performance improvement plans for non-compliant audits and/or reports
- Contribute creative solutions and ownership of daily assignments for seamless communication and systematic completion of routine and special projects
- Working under the direction of the Quality Director, be able to multiple tasks independently with a fast-paced proactive vs. reactive approach to changing priorities
- Maintain tracking tools that will log unacceptable areas in the workflow and staff documentation performance indicating improvement is needed for discussion with management and/or at departmental team meetings
- Assist departments with creating and revising audit tools, as necessary, to ensure audits and reports are value added to the business(s) owner
- Assists in assuring regulatory compliance requiring Clinical RN oversight and review
- Investigates all patient safety/ quality of care issues reported in coordination with the Medical Director and Peer Review Committee
- Responsible for maintaining timely reporting for all regulatory reporting, including medical record review and Quality Improvement Plans/Performance Improvement Plans
- Participates in maintaining compliance with URAC and NCQA accreditation standards
- Complete in-office provider audits and education as deemed appropriate pertaining to patient safety issues
- Train staff. Create training program and job aids as required
- Work with the appropriate teams and departments to manage, plan any implementation of patient safety/ quality of care initiatives across the organization
- Lead all Ambulatory Retrospective Review studies
- ***ALL DUTIES AND REQUIREMENTS MUST BE PERFORMED CONSISTENT WITH THE CHRISTUS HEALTH PLAN STANDARDS AND PERFORMANCE. Other assignments will be given as needed
- Complete in-office provider audits and education as deemed appropriate pertaining to HEDIS and potential quality issues
Requirements:
- Bachelor's Degree in Nursing
- 3 – 5 years
- RN License
Work Type:
Full Time
EEO is the law - click below for more information:
https://www.eeoc.gov/sites/default/files/2023-06/22-088_EEOC_KnowYourRights6.12ScreenRdr.pdf
We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact us at (844) 257-6925.
About CHRISTUS Health
CHRISTUS HEALTH is an international Catholic, faith-based, not-for-profit health system comprised of almost more than 600 services and facilities, including more than 60 hospitals and long-term care facilities, 350 clinics and outpatient centers, and dozens of other health ministries and ventures. CHRISTUS operates in 6 U.S. states, Colombia, Chile and 6 states in Mexico. To support our health care ministry, CHRISTUS Health employs approximately 45,000 Associates and has more than 15,000 physicians on medical staffs who provide care and support for patients. CHRISTUS Health is listed among the top ten largest Catholic health systems in the United States.
More Jobs from This Employer
https://regulatorycareers.raps.org/jobs/19089436/clinical-quality-auditor-senior
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