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Clinical Quality Control Specialist
4 months ago
Do you have 8+ years of experience as a Nurse Practitioner, Registered Nurse, or Physician Assistant working in the rehabilitation unit?
Yes, then this is the job for you
We encourage you to view the job requirements and responsibilities listed down below and apply if you feel like you are a good match
Position Summary: The professional hired for this position will have a broad variety of responsibilities related to quality assurance of the Company’s life care plans. The primary areas of focus for this individual will be clinical in nature. This individual will audit reports, analyze data, identify industry trends, and make recommendations to the company to address trends and deficiencies. Some responsibilities will also include quality control issues of a non-clinical nature including improvement of company processes and procedures.
To be considered, candidates must be ready to work in a deadline-driven environment and be adept at multitasking and managing multiple projects. Prerequisites will include advanced Microsoft Office Suite skills, excellent proofreading, attention to detail, a strong work ethic, and a firm commitment to meeting deadlines.
Essential Job Functions:
· Maintain compliance with company policies, procedures, guidelines, and any applicable requirements.
· Act as the designated Quality Assurance representative on applicable clinical issues by participating in protocol deviation reviews, risk management reviews, and providing oversight of quality events.
· Promote comprehension and compliance with AAPLCP methodology, A Physician’s Guide to Life Care Planning: Tenets, Methods, and Best Practices for Physician Life Care Planners.
· Provide leadership and guidance to department personnel and experts to ensure their understanding of the Company’s processes and methodologies.
· Have the ability to initiate administrative activities to institute quality control procedures.
· Expand, enhance, and manage the Future Medical Requirement Database.
· Research medical advances and populate such advances in databases.
· Provide recommendations for improvements in workflows, system functionality, quality control and reporting.
· Manage corrective and preventative action plans.
· Participate in the training of associate experts.
· Evaluate and manage system risks and deficiencies.
Education and Experience
· Rehabilitation Nurse, or Physician Assistant, with a minimum of a Bachelor's Degree.
· Minimum of 5 years of clinical experience, preferably in a Rehabilitation setting.
· Advanced knowledge of CPT, CDT, HCPCS, ICD-9/10 CM, and MS-DRG medical codes.
· Advanced knowledge of medical terminology, anatomy and physiology, pharmacology, and surgical procedures.
· Advanced knowledge of usual, customary, and reasonable fee data.
· Broad knowledge of risk-based quality system approaches consistent with good clinical practices and life care planning methodology.
· Excellent verbal and written communication skills.
· Ability to identify and/or resolve quality issues and discrepancies with others in a proactive, flexible, and constructive manner.
· Demonstrate a high regard for integrity, ethical conduct, and confidentiality in support of quality-based outcomes.
· Excellent critical thinking, analytical and organizational skills.
· Strong attention to detail.
· Demonstrated ability to work independently in a deadline-driven and multi-project environment.
Preferred Qualifications:
· Familiarity with legal procedures relating to personal injury cases.
· Proficiency in internet research.
· Intermediate to Expert level skillset in Microsoft Office products (Outlook, Work, Excel) and One Note.
Work Schedule:
· 5 day/40-hour work week: Mon - Fri 8:30am - 5:30pm (primarily in-office position)
· Overtime may be required and will be based on business needs.
Work Environment
Physician Life Care Planning’s Core Values: Commitment to Excellence, Superlative Expertise, Integrity, Ownership, Professionalism, Problem-Solving and Customer Centricity.
Physician Life Care Planning is an equal-opportunity employer.
Confidentiality:
Employees will adhere to all federal HIPAA laws and regulations and be willing to sign a confidentiality agreement.
