Job Details
Job Location
Beaverton, OR
Position Type
Full Time
Education Level
QMHA Preferred
Salary Range
$22.00 – $24.76 Hourly
Job Shift
Day
Job Category
Business Operations
Description
Summary:
This role promotes and supports quality of services within the organization, by completing key administrative tasks related to New Narrative clinical, residential, and peer operations. The Quality Improvement Specialists works collaboratively with all staff to ensure high quality data entry, records management, and reviews to meet participant, auditor, contract, and staff requests. The position will assist in the evaluation of participant satisfaction, and the support of compliance, and coordinate with managers and leadership team members around ad hoc projects as necessary.
Essential Duties and Responsibilities:
Program Participant Focus
- Coordinates with agency-wide program participants in reviewing PHI requests, obtaining necessary documentation, advocacy amongst grievances and consumer feedback, and other projects as necessary.
- Assistance in a consumer survey planning, administration, data pulls, and analysis
- Conducts chart reviews alongside QI Manager and Sr QI Specialist to assess for medical necessity, ensure record compliance, and predict training needs
- Fulfill medical records requests and fills records requests in accordance within deadline for audits, licensure, appeals, subpoenas, court orders, benefits inquiries, and external investigations
Clinical and Service Focus
- Supports agency credentialing, including tracking clinical credentials for all staff, individual and agency provider enrollment & reporting to payers, maintaining active credentials in EHR, auditing individual staff credential status and answering staff inquiries regarding credentialing as well as any ad hoc credentialing needs as identified by Human Resources, Billing, or Finance.
- Assists Health Systems Administrator and Medical Department with LabCorp pending invoices, sending results to clinical and pharmacy staff, and other care coordination needs
- Support the Intake Specialist and Clinical Teams as needed to send/receive information from new participants consent documentation through DocuSign, email or USPS
- Support Medical Department with prior authorization needs
- Assists as needed in investigations regarding critical incidents, grievances/complaints, APS cases, appeals, etc.
- Assists teams in chart compliance by uploading scanned documents and attachments from residential teams
- Participates in planning agenda and completing minutes as necessary for monthly and quarterly QI meetings
Database Support
- Ensures data transfer of identified documents from legacy electronic health record to Credible
- Navigates between legacy EHR and Credible as needed to ensure accessibility of documentation, insurance information, required forms, and billing information
- Data entry for content as needed between legacy EHR and Credible
- Initiated and maintain user profiles and assist end-users as needed
- Directly coordinate as directed with New Narrative Pharmacy staff to support data entry, data transfer, data retrieval between databases
- Uploading and maintenance of external databases and mandated reporting (Collective Medical and MOTS)
Positions Reporting: None
Education/Certificates/Licenses/Registration: QMHA preferred or a minimum of two years providing administrative support within a healthcare environment
Experience/Qualifications: Applicants with experience working in Credible and experience in HIPAA compliance a plus.