Quality Management Clinical Analyst

75 Vanderbilt Ave, Staten Island, NY 10304, USA

Req #11964

Monday, May 13, 2024

Quality Management Clinical Analyst

Duties and Responsibilities

• Incident reporting: logging, investigation, ensures written report on file, assists clinical managers with written reports, collates information on a quarterly basis. Provides education to clinical staff regarding risk management and incident reporting.

• Medicare expedited appeals. Review case, writes detailed notice, ensures all information is sent to the QIO.

• Conducts quarterly utilization review including the preparation of the UR report for UR Committee and Professional Advisory Committee (PAC) presentation.

• Infection reporting and infection control: Investigation, record review, writing infection reports, collating and reporting data to PAC.

• Medical record requests: oversight of QM Assistant with processing medical record requests to ensure timely distribution, audit of the record prior to distribution to the requestor.

• Potentially Avoidable Events (PAE): review OASIS PAE reports and conducts record audit of patient experiencing potentially avoidable events to determine agency risk in the event occurrence; prepares PAE report for PAC presentation. Provides feedback to clinical management on deficiencies found.

• Focused record audits related to problem prone areas, performance improvement projects and plans of correction on an as needed basis. Provides feedback to clinical management on deficiencies.

• Assists QM Director/Compliance Officer with complaint and other investigations as requested including review of patient record.

• Vendor Management: conducts personnel file audits and policy review of new vendors to ensure that vendor meet Agency standards.

  Job Qualifications Required

• At least 2 years’ CHHA experience preferably in a quality assurance role.

  Education, Knowledge, Skills and Abilities Preferred

• RN, BSN preferred.

• Word, Excel, Power Point

  Job Type: Full-time

Other details

• Pay Type Salary

• Min Hiring Rate $100,000.00

• Max Hiring Rate $120,000.00

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• 75 Vanderbilt Ave, Staten Island, NY 10304, USA