Corizon Health Compliance Clinical Auditor (RN) - Baltimore, MD in Baltimore, Maryland
We have an exceptional opportunity for a Compliance Clinical Auditor Registered Nurse (RN) to join our healthcare team at Baltimore Pre-Trail Facility located in Baltimore, MD.
Under general direction of the Strategic Compliance Manager, the Strategic Compliance Clinical Auditor (RN) collects, organizes, and tabulates information on healthcare services delivered on the health care unit as it pertains to the settlement agreement.
Qualifications of the Corizon Health Compliance Clinical Auditor Registered Nurse (RN)
Must be committed self-starter, possess excellent editing skills, have the ability to multi-task and prioritize in a highly collaborative team environment
Must be highly organized and detail oriented, and capable of performing under a variety of requirements and deadlines with minimal supervision.
Graduate of an Accredited Nursing School required.
Current, unrestricted, non-probationary status license as a Registered Nurse in the State of Maryland.
Current Basic Life Support/CPR Certification at the Medical Professional Level with AED Training. American Heart Association is the preferred source, but American Red Cross is acceptable.
Specialty certification in correctional healthcare (Certified Correctional Health Professional: CCHP, Certified Correctional Health Professional Nurse: CCHP-RN) is desired.
Experience in principles of Lean and Lean Six Sigma in Healthcare is strongly desired.
3 years clinical healthcare experience required with a minimum of 2 years in a correctional healthcare setting required.
At least 2 years conducting administrative medical compliance analysis, online document management, developing procedural manuals, preparing statistical and organizational charts and presentations.
Knowledge of accreditation standards (NCCHC, ACA, and MCCS) as well as experience with quality improvement programs and clinical auditing preferred.
Authoritative knowledge of Excel, Word, Outlook, SharePoint and PowerPoint required.
Must be able to clearly communicate orally and via written and typed correspondence and notes using various forms, records, charts, and electronic media.
Responsibilities of the Corizon Health Compliance Clinical Auditor Registered Nurse (RN)
In accordance with the settlement agreement executed by plaintiff, gathers, organizes, and tabulates health care services data.
Performs chart reviews utilizing the EPHR and paper health record.
Maintain a high level of knowledge and understanding of the settlement agreement, DPSCS and company polices/ procedures including developed processes and clinical protocols.
Supports the maintenance of audit results and supportive documentation records to comply with all sections of the settlement agreement.
Collaborate with site leadership and the custody partner to ensure effective and efficient corrective action plans are implemented and monitored with documented outcomes for non-compliant trends.
Collaborate with other vendors, subcontractors and custody to address trends of pertaining to deficiencies involving clinical care and coordination of services.
Analyze data and prepare monthly narratives and statistical reports as required by DPSCS.
Perform ongoing review of audit documents for accuracy and completeness prior to data submission.
Ensure all clinical reviews adhere to the specified methodologies.
Attend MAC, Access to Care and CQI meetings for facilities associated with the settlement agreement as requested by DPSCS.
Protects confidentiality of information in written and verbal communications and maintain compliance with HIPAA regulations.
Benefits offered to the Corizon Health Utilization Management Registered Nurse (RN)
Paid Time Off
Medical, Dental and Vision Insurance
401(k) with company match
Free online Continuing Education program
Mentor and Preceptor Programs
For questions contact: Carolyn Coney-Johnson Sr. Clinical Recruiter at 615-660-6814 or Carolyn.firstname.lastname@example.org
This position may require a background check, security clearance, and/or drug screening.
Corizon Health is an Equal Opportunity Employer.
In compliance with federal and state employment opportunity laws, qualified applicants are considered for all positions without regard to race, gender, national origin, religion, age, sexual orientation, disability, Vietnam era veteran, or disabled Veteran status.
Job ID : 14998