Claims Quality Audit Director jobs in Cedar Rapids, IA
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)
The University of Iowa Hospitals & Clinics' is seeking a Director of Nursing Quality and Informatics
The Director of Nursing Quality and Informatics is responsible for leadership and administrative oversight of Nursing Quality in the adult areas of the UI Health Care Medical Center system(including falls, hospital acquired pressure injuries [HAPI], central line associated bloodstream infections [CLABSI], catheter associated urinary tract infections, [CAUTI], wound/ ostomynurses (WOCN), diabetes education, phlebotomy), and Nursing Informatics. The director will partner with the Associate Director accountable for quality within UI Stead Family Children’s Hospital (SFCH) for alignment of practices. The director will be accountable for incorporating area-specific principles, statistical analysis, and methodologies, monitoring internal and external metrics to improve performance. The director will champion and provide leadership for the ongoing development, advancement and optimization of clinical systems and technology that impact patient safety and quality of care. This position will lead and manage the development of structures and processes to evaluate, prioritize, and monitor proposed projects. The director will be accountable for advancing the use of electronic health records to promote high quality, cost-effective health care, patient satisfaction, and staff satisfaction throughout the organization. This position will develop understanding of clinical staff needs and build relationships with staff to assure widespread acceptance, adoption, and meaningful use of clinical information systems.
Work across the UI Health Care Medical Center system and with medical and hospital leaders to create a consistent approach to HR management. Hold unit leaders within a department accountable for high performance and high engagement by articulating expectations, monitoring performance, and providing feedback consistently across areas of responsibility. Approve resource allocations and staffing models. Develop and retain qualified nursing leadership staff and build an effective leadership team.
Develop strategy for budget priorities for the UI Health Care Medical Center system and negotiate among them to address resource issues. Work with own leaders within and external to area to innovatively address and resolve budget issues. Establish reliable revenue cycle processes, including working with nurse managers, nursing supervisors, staff nurses, and providers on documentation to support billed charges.
Work across the UI Health Care Medical Center system to develop, monitor, and enhance quality and service indicators and business processes. Oversee patient satisfaction and quality indicators. Assure that clinical services, educational programs, and research activities are in compliance with all applicable internal and external requirements, including The Joint Commission.
Work across the UI Health Care Medical Center system and with nurse managers, nursing supervisors, associate directors, and directors to implement best care practices and new models of care/service. Address implementation issues across nursing functions and with other departments. Incorporate WE CARE valuesto ensure positive patient/ customer relations.
Develop departmental strategic plan and integrate it with other functions; guide nurse managers, nursing supervisors, associate directors, and directors in developing action plans for implementation; monitor progress to goal completion. Assure integration of goals across functions and across theUI Health Care Medical Center system
Serve as a liaison between staff, providers, and nursing and healthcare leadership across the UI Health Care Medical Center system. Engage and collaborate with providers to identify opportunities for improvement, program development, and capital budgeting. Communicate with external agencies and constituencies to address issues and answer questions. Serve as a liaison among multiple clinical functions to support collaboration in identifying opportunities for improvement and program development.
Support development and implementation of education programs for students and staff in areas of accountability. Maintain a climate of learning that promotes collaborative experiences for students in the University Health Science Colleges and other health care programs. Participate in and present educational programs to staff and University colleges and programs. Develop and support efficient systems for patient education.
Collaborate with other leaders to identify evidence-based practice and research opportunities. Assure access to nursing research and healthcare information. Benchmark best practices with comparable settings to apply across the UI Health Care Medical Center system.
*For a full list of responsibilities please message the contact listed below.
Required Qualifications:
Master’s degree (in nursing, MBA or healthcare related) required. If Master's/Doctorate Degree is in related field other than nursing specialty, a Baccalaureate of Science or Arts Degree in Nursing is required.
Current, valid license to practice nursing in Iowa
7 years of experience in an administrative position in a large, complex health care organization with demonstrated experience in healthcare quality and performance improvement, and informatics
Excellent verbal and written communication skills to serve as a liaison and to collaborate with physicians, staff, patient, and other customers
Demonstrated experience assuring patient safety, quality of care and compliance in a regulatory environment with various state and federal agencies and the Joint Commission
Professional job-related experience fostering or promoting a welcoming and respectful work/academic environment where people of all backgrounds and perspectives feel welcomed and appreciated; or demonstrated the ability to do so.
Demonstrated experience developing budget strategy, priorities and negotiating resource issue
Demonstrated ability to foster a welcoming and respectful workplace environment while recognizing personal differences
Must be proficient in computer and software applications
Desired Qualifications:
Current knowledge of University policies and procedures
Doctor of Nursing Practice (DNP) / Nursing Administration or Doctor of Philosophy (PhD) in Nursing or related field
Minimum 3 years of experience in clinical/healthcare quality and performance improvement
Minimum 3 years of experience in clinical/healthcare informatics, clinical application support or equivalent
Experience working in a Magnet®- designated organization. Working knowledge of Magnet standards required for designation status.
Certification in a role or specialty through a nationally recognized professional nursing certification body. Certification in nursing informatics and/or healthcare quality is desirable
Experience using Epic Clinical Information System and/or Epic Certification(s)
Position and Application details:
In order to be considered for an interview, applicants must upload the following documents and mark them as a "Relevant File" to the submission:
Resume/CV
Cover Letter
Job openings are posted for a minimum of 14 calendar days. This job may be removed from posting and filled any time after the minimum posting period has ended.
Successful candidates will be required to self-disclose any conviction history and will be subject to a criminal background check and credential/education verification. This position is not eligible for University sponsorship for employment authorization. Please contact Morgan Schipper at morgan-schipper@uiowa.edu with any questions.
The University of Iowa Hospitals & Clinics' is seeking a Director of Nursing Quality and Informatics The Director of Nursing Quality and Informatics is responsible for leadership and administrative ov...
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The city is divided into four quadrants, used in addressing. 1st Avenue (U.S. Route 151 Business) divides the north and south sides of the city, and the Cedar River divides east and west. Mays Island, in the middle of the river, is the only area of the city where addresses have no quadrant. Areas outside the city limits that have a Cedar Rapids mailing address do not use the quadrants either.
Except in the downtown area, 1st Avenue and the Cedar River tend to run diagonally instead of along the cardinal directions. Due to the curving of 1st Avenue, there are some areas in western Cedar Rapids ...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Claims Quality Audit Director jobs
$145,087 to $207,349
Cedar Rapids, Iowa area prices were up 0.8% from a year ago