Highland-Clarksburg Hospital
Quality Assurance Analyst
Highland-Clarksburg Hospital, Clarksburg, West Virginia, us, 26306
Job Details
Job LocationHighland- Clarksburg Hospital - Clarksburg, WV
Position TypeFull Time
Job ShiftDay
Description
HIGHLAND CLARKSBURG HOSPITAL
JOB DESCRIPTION
QUALITY ASSURANCE ANALYST/ CREDENTIALING SPECIALIST
JOB SUMMARY:
The QA Analyst will have an active role in all aspects of quality review, inspections and audits to ensure ongoing implementation of quality improvement initiatives. This position will assist in preparing internal audit reports reflecting the results of the work performed. The position will assist with analyzing processes and problem data for trends and aid in making recommendations on possible corrections to processes and documentation. Assist the department as needed to ensure compliance with Joint Commission, OHFLAC, CMS, and all state and federal agencies. QA Analyst/ Credentialing Specialist reports to CQO.
ESSENTIAL FUNCTIONS:Conduct regular quality of documentation audits and coordinate ongoing monitoring of documentation accuracy.Perform quality assurance audits, inspections, monitoring procedures against hospital policy/procedure, regulations, and other guidance materials as applicable.Reviews and identifies policy updates and revisionsResponsible for writing and reviewing quality assurance protocols.Responsible for auditing and monitors current document both electronically and paper on hospital units to ensure completion of documents.Identifies trends in Risk Management.Positively influence hospital through successful contributions, active participation, and identification of compliance gaps.Assists as directed with regulatory agencies to include The Joint Commission, OHFLAC, and CMS.Acts as a liaison between leadership and regulatory bodies for survey purposes.Responsible for analyzing and identifying quality of care issues. Responsible for monitoring performance improvement initiatives.Reports audit results to regulatory agencies and PI Committee and Leadership for corrective measures for monitoring and implementation.Assists with any corrective actions, as necessary.Responsible for handling confidential information and materials and a high degree of attentionOversees incident-reporting system to include investigative follow-up as appropriate and maintaining database for reporting and tracking purposes.Oversees internal investigations related to patient-care and safety in the facility.Adheres with rules and regulations set in bylaws regarding board and board committee matters, including advance distribution of materials before meetings in electronic format.Prepares and distribute meeting packets for Board of Trustees and Boards of Directors.Take, transcribe and distribute minutes for all of the above meetings; coordinate meeting notifications and scheduling.Compile all necessary documentation for credentialing/recredentialing purposes.Maintain privileges. Ensure privileges remain active without lapsing or expiration of privileges.Provides educational and regulatory instruction to residents,faculty, staff, etc.Monitor all quality outcomes for FPPE and OPPE mandatoryreporting for The Joint Commission.Take, transcribe and distribute minutes for several Board Committee Meetings and Company Leadership Meetings.Coordinates Medical Staff activities as requested or required.Ensures program compliance and adherence to Federal, State and other Regulatory bodies such as Federation of State Medical BoardsCoordinates all Hospital Medical Staff Credentialing.Educates regarding requirements when completing an off-service or off-site rotation to ensure educational credit for the rotation.Assists in development of all schedules monthlythat allow the program to maintain compliance with allregulatory agencies.Coordinates hiring process including coordination, assuring completion of required processes including background checks, credentialing,required training certifications and completing exitinterviews.Collaboration with clinical areas, medical staff affairs, information technologies, education and training and other appropriate entities to ensure a timely and efficient onboardingexperience.Supervise Medical Staff personnel to ensure that allcredentialing activities are complete, appropriate andcomply with administrative and medical staff policies / procedures.Identify credentialing issues and irregularities.Develop processes to facilitate credentialing, incorporatingregulatory changes as mandated and addressed standards.Update credentialing and privilege processes to ensure one standard of care.Work with CMO/CEO to assist and ensure compliance with Medical Staff Bylaws and appropriate standards.Schedule / organize / attend all medical staff meetings, functions, and events.Monitors credentials for current medical staff and new hires onboarding.Coordinates medical students onboarding with Staff Development
Qualifications
QUALIFICATIONS:
To perform this job successfully, individual must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Education and Experience:
Bachelor's degree required Masters degree preferred with a minimum of two (2) years of experience in a behavioral health setting. State licensure/certification in healthcare field preferred. Any combination of experience, education, licensure or training that would provide the level of knowledge, skill, and ability required would be considered.
Experience with Microsoft Word and Excel is preferred.
Knowledge of facility practices, policies/procedures, and regulatory agencies preferred.
Familiarity with electronic health records required.
Knowledge of medical billing and collection procedures is required.
Experience with completing insurance applications and medical provider credentialing applications is required. Previous clinical experience in a psychiatric setting is highly desirable. Previous medical office experience preferred.
Licenses & Certifications:
Notary Public required within 90 days of employment.
Language Skills:
Ability to read and interpret instructions, documents and follow procedures.
Excellent interpersonal communication and problem-solving skills.
Excellent communication skills, both oral and written.
Reasoning Ability:
Ability to solve practical problems and deal with a variety of variables as needed.
Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.
Strong organizational analytical skills.
Excellent organizational and time management skills required.
Job LocationHighland- Clarksburg Hospital - Clarksburg, WV
Position TypeFull Time
Job ShiftDay
Description
HIGHLAND CLARKSBURG HOSPITAL
JOB DESCRIPTION
QUALITY ASSURANCE ANALYST/ CREDENTIALING SPECIALIST
JOB SUMMARY:
The QA Analyst will have an active role in all aspects of quality review, inspections and audits to ensure ongoing implementation of quality improvement initiatives. This position will assist in preparing internal audit reports reflecting the results of the work performed. The position will assist with analyzing processes and problem data for trends and aid in making recommendations on possible corrections to processes and documentation. Assist the department as needed to ensure compliance with Joint Commission, OHFLAC, CMS, and all state and federal agencies. QA Analyst/ Credentialing Specialist reports to CQO.
ESSENTIAL FUNCTIONS:Conduct regular quality of documentation audits and coordinate ongoing monitoring of documentation accuracy.Perform quality assurance audits, inspections, monitoring procedures against hospital policy/procedure, regulations, and other guidance materials as applicable.Reviews and identifies policy updates and revisionsResponsible for writing and reviewing quality assurance protocols.Responsible for auditing and monitors current document both electronically and paper on hospital units to ensure completion of documents.Identifies trends in Risk Management.Positively influence hospital through successful contributions, active participation, and identification of compliance gaps.Assists as directed with regulatory agencies to include The Joint Commission, OHFLAC, and CMS.Acts as a liaison between leadership and regulatory bodies for survey purposes.Responsible for analyzing and identifying quality of care issues. Responsible for monitoring performance improvement initiatives.Reports audit results to regulatory agencies and PI Committee and Leadership for corrective measures for monitoring and implementation.Assists with any corrective actions, as necessary.Responsible for handling confidential information and materials and a high degree of attentionOversees incident-reporting system to include investigative follow-up as appropriate and maintaining database for reporting and tracking purposes.Oversees internal investigations related to patient-care and safety in the facility.Adheres with rules and regulations set in bylaws regarding board and board committee matters, including advance distribution of materials before meetings in electronic format.Prepares and distribute meeting packets for Board of Trustees and Boards of Directors.Take, transcribe and distribute minutes for all of the above meetings; coordinate meeting notifications and scheduling.Compile all necessary documentation for credentialing/recredentialing purposes.Maintain privileges. Ensure privileges remain active without lapsing or expiration of privileges.Provides educational and regulatory instruction to residents,faculty, staff, etc.Monitor all quality outcomes for FPPE and OPPE mandatoryreporting for The Joint Commission.Take, transcribe and distribute minutes for several Board Committee Meetings and Company Leadership Meetings.Coordinates Medical Staff activities as requested or required.Ensures program compliance and adherence to Federal, State and other Regulatory bodies such as Federation of State Medical BoardsCoordinates all Hospital Medical Staff Credentialing.Educates regarding requirements when completing an off-service or off-site rotation to ensure educational credit for the rotation.Assists in development of all schedules monthlythat allow the program to maintain compliance with allregulatory agencies.Coordinates hiring process including coordination, assuring completion of required processes including background checks, credentialing,required training certifications and completing exitinterviews.Collaboration with clinical areas, medical staff affairs, information technologies, education and training and other appropriate entities to ensure a timely and efficient onboardingexperience.Supervise Medical Staff personnel to ensure that allcredentialing activities are complete, appropriate andcomply with administrative and medical staff policies / procedures.Identify credentialing issues and irregularities.Develop processes to facilitate credentialing, incorporatingregulatory changes as mandated and addressed standards.Update credentialing and privilege processes to ensure one standard of care.Work with CMO/CEO to assist and ensure compliance with Medical Staff Bylaws and appropriate standards.Schedule / organize / attend all medical staff meetings, functions, and events.Monitors credentials for current medical staff and new hires onboarding.Coordinates medical students onboarding with Staff Development
Qualifications
QUALIFICATIONS:
To perform this job successfully, individual must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Education and Experience:
Bachelor's degree required Masters degree preferred with a minimum of two (2) years of experience in a behavioral health setting. State licensure/certification in healthcare field preferred. Any combination of experience, education, licensure or training that would provide the level of knowledge, skill, and ability required would be considered.
Experience with Microsoft Word and Excel is preferred.
Knowledge of facility practices, policies/procedures, and regulatory agencies preferred.
Familiarity with electronic health records required.
Knowledge of medical billing and collection procedures is required.
Experience with completing insurance applications and medical provider credentialing applications is required. Previous clinical experience in a psychiatric setting is highly desirable. Previous medical office experience preferred.
Licenses & Certifications:
Notary Public required within 90 days of employment.
Language Skills:
Ability to read and interpret instructions, documents and follow procedures.
Excellent interpersonal communication and problem-solving skills.
Excellent communication skills, both oral and written.
Reasoning Ability:
Ability to solve practical problems and deal with a variety of variables as needed.
Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.
Strong organizational analytical skills.
Excellent organizational and time management skills required.