Clinical Quality Assurance Specialist- SF Center- PT

Careers With Purpose

Join our not-for-profit organization that has provided over 100 years of housing and services to seniors with a commitment to quality care and service in a Christian environment.

Facility: GSS SD Sf Ctr
Location: Sioux Falls, SD
Address: 401 W 2nd St, Sioux Falls, SD 57104, USA
Shift: 8 Hours - Day Shifts
Job Schedule: Part time
Weekly

Hours:

16.00
Salary Range: 24.00 - 38.50

Department Details

Our staff is compassionate and dedicated to the residents. The Good Samaritan Society is proud to be one of the largest non-profit providers of senior services in the US.

Since our founding in 1922, we have been driven by our mission and belief. We believe everyone deserves to be treated with respect, dignity, and compassion.

Some of the benefits to working at Good Samaritan Society are

• Competitive Compensation
• Direct access to your earnings daily
• Shift Differential
• Flexible Scheduling Options Available
• Fun, Family Oriented Work Environment
• Excellent Health, Dental and Vision Insurance
• Health Savings Account
• Company Matched 401(k) Retirement Plan
• Paid Time Off
• Salary Increases
• Referral Bonuses
• Advancement Opportunities
• Compassionate Leave
• Education Assistance
• Scholarships and Sponsor ships
• Continuing Education
• Years of Service Recognition Program

Shall be a representative of nursing administration and shall perform necessary delegation and coordination of clinical, operational and managerial activities to accomplish the objectives of the assigned area(s) of nursing. Will incorporate responsibilities related to the quality risk and risk score adjustment programs. Assist with the quality improvement review and audit related to potential quality risk issues and adverse events as part of the quality risk program.

Will complete chart reviews, documentation of findings, referral for medical director review and required reporting. Will perform healthcare effectiveness data and information set (HEDIS) record reviews and assist with clinical questions related to chart reviews. Must work collaboratively with internal and external departments to ensure all aspects of workflow are completed. Will review the risk score adjustment information for medical chart record requests and potential medical chart review.

Manage the chart review process by reviewing the record request list, collaborating with information technology (IT) for file accuracy, coordinating the record requests with providers or vendors and collaborating with the chart review vendor, if applicable. Review the medical visit file to determine individuals requiring outreach to coordinate medical services. Assist members in the coordination of appointments for services. Required to complete tracking documentation of medical record requests, chart reviews and medical visit appointments to ensure status is current.

Must be analytical and have critical thinking, problem solving and decision making skills. Must be organized and able to multi-task. Must be proficient in computer software such as Word and Excel.

May included duties as a liaison for accrediting or governing agencies for services such as sleep medicine.

Graduate from a nationally accredited nursing program preferred, including, but not limited to, Commission on Collegiate Nursing Education (CCNE), Accreditation Commission for Education in Nursing (ACEN), and National League for Nursing Commission for Nursing Education Accreditation (NLN CNEA). Bachelor's degree in nursing preferred.

Minimum of five years of nursing experience. Experience and knowledge of accreditation and regulatory agency standards preferred. Quality, medical coding, and/or risk adjustment experience is preferred.

Currently holds an unencumbered RN license with the State Board of Nursing where the practice of nursing is occurring and/or possess multistate licensure if in a Nurse Licensure Compact (NLC) state. Obtains and subsequently maintains required department specific competencies and certifications. Certified Professional in Healthcare Quality (CPHQ) or medical coding certification preferred, but not required. Quality improvement/assurance personnel with nursing backgrounds can maintain their license without seeking additional hours based on role’s responsibilities.

The Good Samaritan offers an attractive benefits package for qualifying full-time and part-time employees. Depending on eligibility, a variety of benefits include health insurance, dental insurance, vision insurance, life insurance, a 401(k) retirement plan, work/life balance benefits, and a generous time off package to maintain a healthy home-work balance. For more information about Total Rewards, visit  .

The Good Samaritan is an EEO/AA Employer M/F/Disability/Vet. If you are an individual with a disability and would like to request an accommodation for help with your online application, please call or send an email to talent .

The Good Samaritan has a Drug Free Workplace Policy. An accepted offer will require a drug screen and pre-employment background…