Northern Light Health

Department: Quality Perf. Improvement

Position is located: Cianchette Professional Blding

Work Type: Full Time

40 hours per week

Work Schedule: 8:00 AM to 4:30 PM

*This position is remote for Maine residents but may require some onsite work and occasional meetings*

Summary :

The Quality Assurance Auditor will ensure quality reports supplied to Northern Light Health are completed with the highest quality and integrity. The auditor will ensure all quality reporting is in full compliance with the system’s regulatory and contractual agreements. This includes but is not limited to Medicare MSSP/MIPS, promoting interoperability, HEDIS, quality incentive programs/pay for quality, regulatory programs, and reputation programs.

Responsibilities :

Maintains understanding and competency of all clinical quality metrics. Collaborates with the Quality Program Leads and Manager to ensure accurate data capture and standardized data collection methods Conducts quality assurance audits of clinical quality measures and validates technical quality reports for accuracy. Prepares reports to Quality Program Manager that evaluate and define problems and proposes solutions. Assists in educating quality leads, staff members, and providers on pertinent quality components and documentation requirements. Performs other duties as delegated by management for which the employee is qualified to perform. Demonstrates self-motivation with an ability to work independently, prioritize needs, pay attention to detail, organize complex processes, think creatively, and interact in a professional manner. Demonstrates the ability to work collaboratively with members, physicians, other medical disciplines and management staff. Knows and follows organizational and departmental policies and procedures applicable to assigned duties. Participates in required organizational and departmental patient safety education programs and other activities designed to improve departmental and organizational patient safety.

Other Information :

Able to work effectively at all levels in an organization. Independent travel to various sites required. Collaborates with Quality Program Manager to create individual self-development plan. Ability to demonstrate working knowledge of medical terminology and patient records interpretation. Attention to detail and high critical thinking skills. Exceptional communication skills both written and verbal Excellent active listening skills Problem solving and root cause identification skills Must have knowledge of the following software: Project Management, Workflow Management, Microsoft Excel, Word, and PowerPoint Understanding of the health care delivery setting

Competencies and Skills

• 5+ years of relative work experience required.
• Achieves Results: Sets high standards for their own outcomes and seizes opportunities to engage others towards objectives. Consistently moves forward with direct actions in order to attain or exceed objectives. Manages their own time effectively to accomplish assigned tasks. Successfully prioritizes multiple projects and duties as needed.
• Behaves with Integrity and Builds Trust: Acts consistently in line with the core values, commitments and rules of conduct. Leads by example and tells the truth. Does what they say they will, when and how they say they will, or communicates an alternate plan.
• Cultivates Respect: Treats others fairly, embraces and values differences, and contributes to a culture of diversity, inclusion, empowerment and cooperation.
• Effectively Communicates: Listens, speaks and writes appropriately, using clear language. Communication methods are fitting to the message(s), audience, and situation and follow-ups are regular and timely. Shows that important (non-) verbal information is absorbed and understood and asks further questions to clarify when necessary. Expresses ideas and views clearly to others and has ability to adjust use of language to the audiences' level.
• Fosters Accountability: Creates and participates in a work environment where people hold themselves and others accountable for processes, results and behaviors. Takes appropriate ownership not only of successes but also mistakes and works to correct them in a timely manner. Demonstrates understanding that we all work as a team and the quality and timeliness of work impacts everyone involved.
• Word processing, spreadsheets, data entry, database experience and other computer related skills.
• Practices Compassion: Exhibits genuine care for people and is available and ready to help; displays a deep awareness of and strong willingness to relieve the suffering of others.
• Serves Others: Strives to understand, meet and exceed the expectations and requirements of internal and external customers which may include the people and communities in our service areas. Develops and maintains relationships, alliances and coalitions within and outside the organization and leverages them in order to obtain information, support, and promote cooperation and collaboration.

Education

• Required Associate's Degree - 4 years of related experience in lieu of degree

Working Conditions

• Work with computers, typing, reading or writing.
• Prolonged periods of sitting.