Senior Clinical Quality Auditor
Christus Health

Irving, Texas

This job has expired.


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 experience
  • Registered Nurse

Work Type:

Full Time


This job has expired.

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