Claims Quality Audit Director directs and oversees the operations of the claims quality audit department to follow the audit policies, procedures and regulation. Provides professional knowledge and guidance on technical or procedural problems. Being a Claims Quality Audit Director creates claims audit policies and procedures. May recommend changes in claims processing procedures. Additionally, Claims Quality Audit Director typically Requires a bachelor's degree. Typically reports to top management. The Claims Quality Audit Director manages a departmental sub-function within a broader departmental function. Creates functional strategies and specific objectives for the sub-function and develops budgets/policies/procedures to support the functional infrastructure. To be a Claims Quality Audit Director typically requires 5+ years of managerial experience. Deep knowledge of the managed sub-function and solid knowledge of the overall departmental function. (Copyright 2024 Salary.com)
Position Summary
The Chief Quality Officer coordinates the organization-wide performance improvement program, the risk management program and ensures compliance with regulatory requirements. In addition, this role may, but is not all inclusive of the following: infection control.
Essential Job Functions:
1. Oversees the development, coordination and evaluation of effective hospital wide quality management programs, including mandatory required reporting measures (core measures, HCAPHS).
2. Directs broad operations to ensure facility wide compliance with all regulatory and accreditation agencies and hospital requirements.
3. Ensures collaborative departmental approach to long-range strategic operational planning, care and service
design and development of organizational policies that reflect the mission of the organization.
4. Continuously assesses, measures, and improves departmental performance.
5. Demonstrates responsible management of all Quality Management Departmental resources.
6. Demonstrates managerial competency. Ensures professional development needs of management and staff are met.
Position Requirements:
A. Licensure/Certification/Registration:
Current License-State of Oklahoma
B. Education:
Graduate of Accredited School of Nursing, BSN or related field. Masters degree preferred
C. Experience:
Minimum of 5-8 years in nursing or other healthcare management. Extensive knowledge of various regulatory
agencies and required standards, such as Joint Commission, State, and CMS, etc.
D. Special qualifications:
Effective communication and interpersonal skills to interact with patients, visitors, physicians, and
department/hospital staff members. Self-motivated, independent, professional, creative, and dependable. Able to
merge clinical and financial processes. Must have the ability to analyze, assemble, and prepare statistical reports.
Basic office and computer skills.
III. Degree of Supervision Required:
Involves general guidance and direction by Administration. The Chief Quality Officer is expected to perform most
job duties independently and in accordance with established departmental and hospital policies/procedures.
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0 Claims Quality Audit Director jobs found in Lawton, OK area