Clinical Quality Specialist- Luther Manor- FT Day
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Job Location:
Sioux Falls, SD - USA
Monthly Salary:
$ 24 - 38
Posted on:
2 days ago
Vacancies:
1 Vacancy
Job Summary
Sanford Health is one of the largest and fastest-growing not-for-profit health systems in the United States. Were proud to offer many development and advancement opportunities to our nearly 50000 members of the Sanford Family who are dedicated to the work of health and healing across our broad footprint.
Work Shift:
8 Hours - Day Shifts (United States of America)Scheduled Weekly Hours:
32Salary Range: $24.00 - $38.50Union Position:
NoDepartment Details
Our staff is compassionate and dedicated to the residents. The Good Samaritan Society is proud to be one of the largest non-profit providers of senior services in the US.Since our founding in 1922 we have been driven by our mission and belief. We believe everyone deserves to be treated with respect dignity and compassion.
Some of the benefits to working at Good Samaritan Society are
Competitive Compensation
Direct access to your earnings daily
Shift Differential
Flexible Scheduling Options Available
Fun Family Oriented Work Environment
Excellent Health Dental and Vision Insurance
Health Savings Account
Company Matched 401(k) Retirement Plan
Paid Time Off
Salary Increases
Referral Bonuses
Advancement Opportunities
Compassionate Leave
Education Assistance
Scholarships and Sponsorships
Continuing Education
Years of Service Recognition Program
Summary
Shall be a representative of nursing administration and shall perform necessary delegation and coordination of clinical operational and managerial activities to accomplish the objectives of the assigned area(s) of nursing.Job Description
Will incorporate responsibilities related to the quality risk and risk score adjustment programs. Assist with the quality improvement review and audit related to potential quality risk issues and adverse events as part of the quality risk program. Will complete chart reviews documentation of findings referral for medical director review and required reporting. Will perform healthcare effectiveness data and information set (HEDIS) record reviews and assist with clinical questions related to chart reviews. Must work collaboratively with internal and external departments to ensure all aspects of workflow are completed. Will review the risk score adjustment information for medical chart record requests and potential medical chart review. Manage the chart review process by reviewing the record request list collaborating with information technology (IT) for file accuracy coordinating the record requests with providers or vendors and collaborating with the chart review vendor if applicable. Review the medical visit file to determine individuals requiring outreach to coordinate medical services. Assist members in the coordination of appointments for services. Required to complete tracking documentation of medical record requests chart reviews and medical visit appointments to ensure status is current. Must be analytical and have critical thinking problem solving and decision making skills. Must be organized and able to multi-task. Must be proficient in computer software such as Word and included duties as a liaison for accrediting or governing agencies for services such as sleep medicine.Qualifications
Graduate from a nationally accredited nursing program preferred including but not limited to Commission on Collegiate Nursing Education (CCNE) Accreditation Commission for Education in Nursing (ACEN) and National League for Nursing Commission for Nursing Education Accreditation (NLN CNEA). Bachelors degree in nursing preferred.Minimum of five years of nursing experience. Experience and knowledge of accreditation and regulatory agency standards preferred. Quality medical coding and/or risk adjustment experience is preferred.
Currently holds an unencumbered RN license with the State Board of Nursing where the practice of nursing is occurring and/or possess multistate licensure if in a Nurse Licensure Compact (NLC) state. Obtains and subsequently maintains required department specific competencies and certifications. Certified Professional in Healthcare Quality (CPHQ) or medical coding certification preferred but not required. Quality improvement/assurance personnel with nursing backgrounds can maintain their license without seeking additional hours based on roles responsibilities.
Sanford is an EEO/AA Employer M/F/Disability/Vet.
If you are an individual with a disability and would like to request an accommodation for help with your online application please call 1- or send an email to
Required Experience:
IC
Key Skills
- Quality Assurance
- FDA Regulations
- Data Collection
- Food Safety Experience
- ISO 9001
- Mobile Devices
- Root cause Analysis
- Quality Systems
- OSHA
- Food Processing
- Quality Management
- cGMP
About Company
Marshfield Clinic is a health care system with over 50 locations in northern, central, and western Wisconsin. Marshfield Clinic Don't just live. Shine.
