AFMC
Outreach Specialist RN IOC - Central Arkansas
AFMC, Little Rock, Arkansas, United States, 72208
Outreach Specialist RN IOC - Central Arkansas
Responsible for quality of care inspections and assessments to determine legitimacy and necessity of medical services in compliance with government reimbursement policies. SCOPE OF POSITION: Review findings may be referred to a physician advisor for final determination. Collaborate with medical and other professional staff to accomplish goals within designated timeframes. Answers directly to the outreach supervisor and is accountable for ensuring services are implemented according to strategic directives and contract deliverables. ESSENTIAL JOB FUNCTIONS: Collaborate with team members to develop strategies to implement quality of care inspections and IOC objectives throughout the state of Arkansas Function as a resource for non-clinical staff by providing oversight and follow-up for clinically related questions or issues Write effective and accurate review summaries and submit within appropriate time frame. Refer all cases that do not meet established medical necessity criteria to the physician advisor. Maintain files for recording and reporting in accordance with established procedures. Perform site surveys as required. Must be able to travel within the State as needed to accomplish required site visits. Seek direction from Supervisor for any questions or issues during the review process. Daily quotas may be added to meet contract deliverables as needed. Participate in the planning, development, implementation, delivery, and evaluation of multiple program activities with respect to each quality of care assessment. Communicate effectively with internal and external clients. Understand and utilize project-tracking database to document, collect, and interpret data to meet contractual and other reporting requirements. Maintain accurate statistical data. Maintain log of all onsite visits, including date, time, location, name, topics covered, feedback received, and recommendations made from the visit. Identify, present, and discuss progress and issues relating to focus areas and suggest solutions to assist in program development Ensure all activities address designated performance goals and are performed within designated time frame Maintain knowledge of specific projects including contract, contract deliverables, policies, and procedures, etc. Adhere to format, content, and style guidelines, considering usability and ensuring accuracy, consistency, and quality Follow AFMC, state and federal protocols regarding data confidentiality/security and HIPAA compliance Additional duties as assigned KNOWLEDGE, SKILLS, AND ABILITIES: Intermediate level computer skills (Excel, Word, Power Point and Outlook). Type 50 wpm. Exceptional skills in business English and spelling are required. Ability to maintain confidentiality. Strong oral and written communication skills. Ability to compile presentations. Creativity. Ability to meet deadlines. Flexibility. Knowledge of HIT/EHR. Medical terminology. Ability to work collaboratively and independently to achieve stated goals. Initiative. Ability to relate professionally and positively with staff, business partners, customers, constituents, recipients, and the public. Ability to multitask. Ability to prioritize. Strong organizational skills. Professionalism. Ability to read, interpret and apply laws, rules, and regulations. Knowledge of quality improvement processes and techniques. Valid driver’s license and active Auto insurance required Travel including overnight required. PHYSICAL AND SENSORY REQUIREMENTS: Mobility, reaching, bending, lifting, grasping, ability to read and write, ability to communicate with personnel, ability to remain calm under stress and ability to travel as needed. Must be able to lift and transport 25 pounds. EDUCATION AND EXPERIENCE: Required: Diploma or associate degree in nursing. Licensed as a Registered Nurse in the state of Arkansas, without restrictions. Three (3) years of experience in behavioral health, social service, or juvenile justice. EQUAL OPPORTUNITY EMPLOYER: AFMC, Inc. is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against on the basis of disability or any other status protected by federal, state and/or local law.
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Responsible for quality of care inspections and assessments to determine legitimacy and necessity of medical services in compliance with government reimbursement policies. SCOPE OF POSITION: Review findings may be referred to a physician advisor for final determination. Collaborate with medical and other professional staff to accomplish goals within designated timeframes. Answers directly to the outreach supervisor and is accountable for ensuring services are implemented according to strategic directives and contract deliverables. ESSENTIAL JOB FUNCTIONS: Collaborate with team members to develop strategies to implement quality of care inspections and IOC objectives throughout the state of Arkansas Function as a resource for non-clinical staff by providing oversight and follow-up for clinically related questions or issues Write effective and accurate review summaries and submit within appropriate time frame. Refer all cases that do not meet established medical necessity criteria to the physician advisor. Maintain files for recording and reporting in accordance with established procedures. Perform site surveys as required. Must be able to travel within the State as needed to accomplish required site visits. Seek direction from Supervisor for any questions or issues during the review process. Daily quotas may be added to meet contract deliverables as needed. Participate in the planning, development, implementation, delivery, and evaluation of multiple program activities with respect to each quality of care assessment. Communicate effectively with internal and external clients. Understand and utilize project-tracking database to document, collect, and interpret data to meet contractual and other reporting requirements. Maintain accurate statistical data. Maintain log of all onsite visits, including date, time, location, name, topics covered, feedback received, and recommendations made from the visit. Identify, present, and discuss progress and issues relating to focus areas and suggest solutions to assist in program development Ensure all activities address designated performance goals and are performed within designated time frame Maintain knowledge of specific projects including contract, contract deliverables, policies, and procedures, etc. Adhere to format, content, and style guidelines, considering usability and ensuring accuracy, consistency, and quality Follow AFMC, state and federal protocols regarding data confidentiality/security and HIPAA compliance Additional duties as assigned KNOWLEDGE, SKILLS, AND ABILITIES: Intermediate level computer skills (Excel, Word, Power Point and Outlook). Type 50 wpm. Exceptional skills in business English and spelling are required. Ability to maintain confidentiality. Strong oral and written communication skills. Ability to compile presentations. Creativity. Ability to meet deadlines. Flexibility. Knowledge of HIT/EHR. Medical terminology. Ability to work collaboratively and independently to achieve stated goals. Initiative. Ability to relate professionally and positively with staff, business partners, customers, constituents, recipients, and the public. Ability to multitask. Ability to prioritize. Strong organizational skills. Professionalism. Ability to read, interpret and apply laws, rules, and regulations. Knowledge of quality improvement processes and techniques. Valid driver’s license and active Auto insurance required Travel including overnight required. PHYSICAL AND SENSORY REQUIREMENTS: Mobility, reaching, bending, lifting, grasping, ability to read and write, ability to communicate with personnel, ability to remain calm under stress and ability to travel as needed. Must be able to lift and transport 25 pounds. EDUCATION AND EXPERIENCE: Required: Diploma or associate degree in nursing. Licensed as a Registered Nurse in the state of Arkansas, without restrictions. Three (3) years of experience in behavioral health, social service, or juvenile justice. EQUAL OPPORTUNITY EMPLOYER: AFMC, Inc. is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against on the basis of disability or any other status protected by federal, state and/or local law.
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