Claims Quality Audit Supervisor supervises and coordinates daily activities of claims quality auditors. Provides assistance in developing claims audit policies and procedures. Being a Claims Quality Audit Supervisor solves day-to-day problems and monitors the results of daily staff activities, reports critical issues and problems to the management. Typically requires a bachelor's degree. Additionally, Claims Quality Audit Supervisor typically reports to a manager. The Claims Quality Audit Supervisor supervises a group of primarily para-professional level staffs. May also be a level above a supervisor within high volume administrative/ production environments. Makes day-to-day decisions within or for a group/small department. Has some authority for personnel actions. Thorough knowledge of department processes. To be a Claims Quality Audit Supervisor typically requires 3-5 years experience in the related area as an individual contributor. (Copyright 2024 Salary.com)
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:
Please note benefits are based on eligibility according to full-time, part-time or PRN status classification.
DUTIES AND RESPONSIBILITIES:
Compounding Pharmacy Technician:
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.
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