Quality Assurance Auditor

Northern Light Health
Job Description
To view the complete job description and apply, please visit: https://northernlighthealth.org/Careers/Search.aspx?txt=Quality%20Assurance%20Auditor&cat=0&sch=0&shi=0&com=0&pos=0

JOB SUMMARY:


The Quality Assurance Auditor will ensure quality reports supplied to Beacon Health, NLH, and their members are completed with the highest quality and integrity. This position will ensure all quality reporting is in full compliance with the Population Health and NLH system contractual agreements including but not limited to:

· Medicare MSSP/MIPS

o Clinical Quality

o Promoting Interoperability

o Improvement Activities

· Medicaid Meaningful Use

· HEDIS

· Other Regulatory and Reputation Programs e.g. Leapfrog, Joint Commission, etc.



The Quality Assurance Auditor reports directly to the Beacon Health Quality Program Manager. The Quality Assurance Auditor will work closely with the Quality Program Leads and IT and programming experts. For Beacon Health functions, the Quality Assurance Auditor will work closely with both NLH and non-NLH members.



PRIMARY RESPONSIBILITIES:

1. *Maintains understanding and competency of all clinical quality metrics



2. *Collaborates with the Quality Program Leads and Manager on standardized data collection methods



3. *Plans and conducts quality assurance audits of clinical quality measures



4. *Validates technical quality reports for accuracy



5. *Prepares reports to Quality Program Manager that evaluate and define problems and proposes solutions



6. *Assists in educating quality leads, staff members, and providers on pertinent quality components and documentation requirements



7. *Collaborates with Quality Program Leads and Clinical Data Management team to ensure accurate data capture



8. Knows and follows organizational and departmental policies and procedures applicable to assigned duties.



9. Participates in required organizational and departmental patient safety education programs and other activities designed to improve departmental and organizational patient safety.



10. Reports serious events and incidents in accordance with established hospital policy and procedure.



11. Performs other duties as delegated by management for which the employee is qualified
to perform.



12. Demonstrates self-motivation with an ability to work independently, prioritize needs, pay attention to detail, organize complex processes, think creatively, and interact in a professional manner



13. Demonstrates the ability to work collaboratively with members, physicians, other medical disciplines and management staff.


*Denotes essential job functions.

 

REQUIREMENTS:

· Associates Degree

· 5 years' experience working in medical auditing or similar experience

· Knowledge of medical terminology, medications, medical specialties and treatment protocols

· Familiar with all settings across the care continuum.

· Must have knowledge of the following software: Database, Project Management, Workflow Management, Microsoft Excel and Word


· Clinical experience preferred i.e. Health Record Analyst, Certified Medical Assistant (CMA) or License Practical Nurse (LPN).
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