SWHRCIN SPL QUAL AUDITOR I RN SWHR CIN at Southwestern Health Resources CIN in Pittston, Pennsylvania

Job Description:

Quality Auditor Specialist I (RN) SWHR CIN

Southwestern Health Resources, a national leader in population health, is looking for a qualified Quality Auditor Specialist I (RN) SWHR CIN to join our Quality team.

If you're looking for a rewarding career at a patient-centered organization with work-life balance and comprehensive benefits, we want to hear from you.

Position Highlights

• Work location: Southwestern Health Resources Headquarters, 1603 Lyndon B. Johnson Freeway, Farmers Branch, TX 75234 • Work environment: PCP Quality • Work hours: Full-time, 40 hours weekly, Monday through Friday, Day-shift • Please note: The Quality Auditor Specialist I (RN) SWHR CIN is employed by SWHR. SWHR is a clinically integrated network formed by Texas Health and UT Southwestern. • Salary range: $33.27-$49.29 per hour (based on relevant experience)

Southwestern Health Resources (SWHR) is a patient-centered clinically integrated network of 29 hospital locations and more than 5,500 physicians and other clinicians. Formed by Texas Health and UT Southwestern, two of the region's leading healthcare systems, SWHR delivers nationally preeminent, highest-quality care in 16 counties across North Texas. SWHR is also the parent organization of Care N' Care Insurance Co., a regional Medicare Advantage Plan serving more than 13,500 members in the region.

The SWHR network includes physicians from UT Southwestern and Texas Health, and independent community primary care and specialty physicians. In partnership, our team implements physician-driven, value-based care strategies to coordinate care for more than 700,000 patients, resulting in lower costs and high-quality care. In 2020, the Centers for Medicare & Medicaid Services released the annual financial and quality results and, based on the report, SWHR is one of the nation's leading Next Generation Accountable Care Organizations, having saved nearly $120 million since joining the program in 2017.

Qualifications

Education
Associate's Degree Nursing from an accredited RN program (ADN) Required Or
Bachelor's Degree Nursing from an accredited RN program (BSN) Required

Experience
4 Years' Experience in healthcare to include 2 years of healthcare auditing (with Bachelor's Degree) Required or
6 Years' Experience in healthcare to include 2 years of healthcare auditing (with Associate's Degree) Required

Licenses and Certifications
RN - Registered Nurse Active Texas RN license Upon Hire Required

Skills
Ability to read and interpret all types of medical records, including physician documentation.
Independent problem identification/resolution, critical thinking and decision making skills
Must be able to prioritize, plan, and handle multiple tasks/demands simultaneously.
Possess planning, organizing, conflict resolution, negotiating, collaborative and interpersonal skills.
Ability to work collaboratively in a team-oriented environment with a strong customer-service orientation
Strong written and verbal communication skills; strong analytical, organizational and time management skills required
Proficiency in Microsoft Office Word, Excel and Access.

Duties

• Complete Quality Audits in a timely and accurate manner • Complete audits according to specifications • Communicate to Supervisor/Manager audit barriers, obstacles or concerns • Meet required audits per day target • Participate in quality improvement initiatives, such as, but not limited to Quality Mobile • Health Services, documentation in the electronic health record, and/or provide clinical expertise to develop clinical recommendations for quality metrics, clinical workflows, research and education • Utilize audit findings to facilitate and provide education • Communicate quality measures that have consistently not been meet. Identify and provide feedback on measures that need to be ordered/obtained via the appropriate process • Will identify areas of targeted quality measures adherence that need improvement and organize as needed training sessions with assigned providers and/or their administrative staff. • Participate in development as subject matter expert in education, resource development and or training tools. Utilize clinical expertise for development and use of auditing tools/templates/resources and education

*Other Duties as assigned

Why Southwestern Health Resources
As a Southwestern Health Resources you'll enjoy: comprehensive benefits, including a 401(k) with match; paid time off; competitive health insurance choices; healthcare and dependent care spending account options; wellness programs to keep you and your family healthy; tuition reimbursement; a student loan repayment program; and more.

Moving healthcare forward
At the heart of SWHR are people who help people. We care about those we serve and each other. To be the national leader in providing population-based healthcare, our more than 850 employees use their knowledge, data insights and clinical experience to deliver care to the right patient, at the right time and in the right setting. By connecting physicians to patients and clinical insights to better outcomes, SWHR lowers costs, optimizes value, and builds a better healthcare system for all.

We invite you to learn more about us at www.southwesternhealth.org .

Let's move healthcare forward - together.

Apply Now