Sanford Bemidji
Clinical Quality Specialist- Luther Manor- FT Day
Sanford Bemidji, Sioux Falls, South Dakota, United States, 57102
# Careers With PurposeClinical Quality Specialist- Luther Manor- FT Day page is loaded## Clinical Quality Specialist- Luther Manor- FT Daylocations:
SD, Sioux Fallstime type:
Full timeposted on:
Posted Todayjob requisition id:
R-0245787**Sanford Health is one of the largest and fastest-growing not-for-profit health systems in the United States. We’re proud to offer many development and advancement opportunities to our nearly 50,000 members of the Sanford Family who are dedicated to the work of health and healing across our broad footprint.**Work Shift:8 Hours - Day Shifts (United States of America)Scheduled Weekly Hours:32Salary Range: $24.00 - $38.50**Union Position:**No**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 Sponsorships
• Continuing Education
• Years of Service Recognition Program**Summary**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.**Job Description**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.**Qualifications**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.**Sanford 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 1-877-673-0854 or send an email to talent@sanfordhealth.org.** #J-18808-Ljbffr
SD, Sioux Fallstime type:
Full timeposted on:
Posted Todayjob requisition id:
R-0245787**Sanford Health is one of the largest and fastest-growing not-for-profit health systems in the United States. We’re proud to offer many development and advancement opportunities to our nearly 50,000 members of the Sanford Family who are dedicated to the work of health and healing across our broad footprint.**Work Shift:8 Hours - Day Shifts (United States of America)Scheduled Weekly Hours:32Salary Range: $24.00 - $38.50**Union Position:**No**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 Sponsorships
• Continuing Education
• Years of Service Recognition Program**Summary**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.**Job Description**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.**Qualifications**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.**Sanford 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 1-877-673-0854 or send an email to talent@sanfordhealth.org.** #J-18808-Ljbffr