Claims Quality Audit Supervisor jobs in Idaho

Mountain View Hospital is looking for a Clinical Nurse Reporting Supervisor to join our team!

JOB SUMMARY:

The Clinical Nurse Reporting Supervisor will lead and manage a clinical quality reporting team that consists of individuals with credentials as a CNA or medical record/medical practice or coding experience. Duties include abstracting clinical data, reviewing charts, supporting and submitting CMS mandated measures including eCQMs (electronic Clinical Quality Measures), as well as support process improvement projects in targeted clinical areas/departments. The Clinical Nurse Reporting Supervisor will also play an integral role in education of nursing and clinical staff on CAHPS surveying and process improvement for better patient experience outcomes.

The goal of this position is to guide the team to successfully support projects, meet deadlines and submissions requirements for CMS reporting requirements and manage the team to continually develop their skills and contribute to improving the quality and safety environment of Mountain View Hospital. The Clinical Nurse Reporting Supervisor will contribute to the strategy of the Quality Analytics division, the Quality department and business partners across the organization. The position will manage the day-to-day work of staff and team while also working closely with clinical and administrative leaders across organization to improve efficiency, data delivery and analytics support.

BENEFITS:

Taking care for our community starts with taking care of our own team. Mountain View Hospital is proud to offer its employees competitive and comprehensive benefit packages. Benefits include:

• Medical, Dental and Vision Insurance
• Paid Time Off (vacation, holidays and sick days) and Medical Paid Time Off
• Retirement Plans (401K with up to 6% match)
• Earned Quarterly Bonus Program
• Education Reimbursement Program
• Discount for medically necessary procedures performed at Mountain View Hospital and Idaho Falls Community Hospital

Please note benefits are based on eligibility according to full-time, part-time or PRN status classification.

DUTIES AND RESPONSIBILITIES:
Compounding Pharmacy Technician:

• Set goals and objectives for Clinical Quality Reporting team that are clear, challenging, and aligned with the goals and priorities of Mountain View Hospital, the Quality department and Quality Analytics.
• Coordinates Clinical Quality Reporting team to meet data collection requirements to support timely completion and validation of all public reporting projects for Inpatient and outpatient Quality Core Measures and CMS.
• Works closely with Clinical Quality Reporting Team to manage appropriate data extracts, reports and submissions are handled in a timely manner to specifications.
• Work closely with the Patient Experience Manager to identify areas of weakness and strength to improve patient experience and maintain CAHPS scoring.
• Assist in the promotion and education of process changes as it relates to the clinical staff and patient experience.
• Communicates with clinical and administrative staff and leaders across Mountain View Hospital to share quality outcomes and opportunities related to the team's work.
• Serves as expert resource and consultant related to projects needing clinical data collection either through electronic sourcing or manual abstraction.
• Works with Point of Care, Cerner, IT and other teams to identify technical solutions that can make current and on-going work more efficient and effective.
• Provides project leadership for assigned analytics initiatives. Oversee cross functional teams with project prioritization, scoping, and resource allocation.
• Maintains expert knowledge of the business content, analytical methods, diverse data sources, and IT systems necessary to achieve unit, division and department goals.
• Supports and strengthens organizational priorities such as data transparency, security and compliance across analytics projects.
• Oversee human resource functions including hiring, firing, training, mentoring and continuous performance management to maintain the highest quality workforce.
• Manages and engages team members through coaching, one on ones, and development planning while instilling a team orientation and customer focused priorities.
• Promotes individual team member's professional growth and development.
• Assigns, prioritizes and delegates tasks and responsibility to team members as appropriate.
• Supports hands-on frontline work as needed during periods of high demand.

About Mountain View:

Mountain View Hospital and our 29 affiliate clinics are committed to providing compassionate, cutting edge care to our patients. We serve the entire Snake River Valley – all the way from Pocatello to Rexburg. Our medical capabilities span everything from wound care to urgent care, oncology to neurology, physical therapy to speech therapy, a Level III NICU, robust robotic surgery department and a continuously expanding rural health practice.

Our work environment is mission driven, people-centric and supportive. It is what sets apart and makes people excited to come to work each day. If you are looking for a career where you can make a difference in your community, we invite you to apply.

Education/Certification: Minimum Associates Degree of Nursing and current RN Licensure.

Experience: Preferred 2 years of CMS and quality reporting experience and previous experience with clinical processes and patient care. Experience with analytical environments (e.g. data, warehouse, business intelligence.) Expertise in healthcare quality and safety measurement. Experience with process improvement methods. Knowledge of ECQMs, CMS core measures, and CAHPS survey platforms, also preferred. Previous experience with project management would be beneficial to the candidate.

Equipment/Technology: Use of computer and Electronic Health Record software is required. Previous experience with health IT Systems and data reports preferred with experience in spreadsheet and database applications. Experience with Mountain View clinical operations, billing and reporting requirements also preferred, but not required.

Language/Communication: Medical record review/abstraction knowledge in multiple specialties. Excellent collaboration, interpersonal, meeting facilitation, presentation, written, listening, and verbal communication skills. Ability to identify and implement appropriate process/procedure changes in a unified format using problem solving and planning skills with department managers and administrative officers, to improve the quality metrics for Mountain View Hospital. Dynamic presentation skills and ability to develop clear and presentable documentation required.

Mental Capabilities: Strong attention to detail, problem solving, and organizational skills. Able to define problems, collect data and deal with stressful situations in a tactful professional manner. Knowledge of how to apply analytical methods and data to health care problem spaces.