Clinical Quality Analyst
Description
At SCP Health, what you do matters
As part of the SCP Health team, you have an opportunity to make a difference. At our core, we work to bring hospitals and healers together in the pursuit of clinical effectiveness. With a portfolio of over 8 million patients, 7500 providers, 30 states, and 400 healthcare facilities, SCP Health is a leader in clinical practice management spanning the entire continuum of care, including emergency medicine, hospital medicine, wellness, telemedicine, intensive care, and ambulatory care.
Why you will love working here:
- Strong track record of providing excellent work/life balance
- Comprehensive benefits package and competitive compensation
- Commitment to fostering an inclusive culture of belonging and empowerment through our core values - collaboration, courage, agility, and respect.
What you’ll be doing:
The Clinical Quality Analyst position plays a critical role in improving the quality of patient care through quality data extraction and analytical support for MIPS, Core Measures, and Value based as well as other quality/risk documentation. The Clinical Quality Analyst will work through quality initiatives with clinical reviews on designated charts to validate documentation and services performed.
- Abstracts, analyzes, and communicates clinical data sets according to defined quality standards established by CMS, HEDIS, TJC (The Joint Commission), or other designated quality entities to support reporting for variation, trending, and provider education. Reviews and identifies quality indictors in SCP emergency/ hospital medicine service lines as well as other integrated service lines via provider documentation and other data feeds. Major metrics are highlighted below:
- Core Measure extraction
- Merit Based Incentives (MIPS), MVP
- Quality indicators as identified by SCP Office of Medical Affairs or designated OMA committees.
- Risk management extraction as developed.
- Special audits as needed for quality initiatives/research.
- Utilizes the Quality Query system or provider’s electronic medical record systems to query providers on “missed” documentation on quality initiatives. Works with providers to obtain the adequate information and educates provider on non-compliant documentation.
- Maintains and updates knowledge regarding national quality and clinical documentation standards. Has the ability to read and apply CMS/TJC/HEDIS specification manuals in order to complete abstraction of data sets assigned.
- Proficient at ICD-10 and Procedure code identification to provide support in reporting misalignment between data sets during extraction and outcomes reviews.
- Identifies through extraction review the missing data elements and works with Revenue Cycle/Operations /Information Technology SCP employees to improve chart integrity for quality extraction.
- Identifies through extraction errors or concerns in workflow and works with the coding department to improve data quality and coding on MIPS and other key quality, operational or patient flow
- When noted, the Clinical Quality Coder I will correct quality errors and stat code errors in the system to improve data integrity in facility dashboards and provider scorecards.
Who/What we are looking for:
- You have experience with clinical data extraction from medical charts.
- You have one year of clinical audit, core measure/MIPS, risk management or case management experience preferred.
- You have a professional Certificate or equivalent Degree Program in Coding or Billing
- You have an active RHIA, RHIT or CCS certification preferred (Registered Health Information Administrator, Registered Health Information Technician, Certified Coding Specialist)
- You have one year of healthcare coding, billing, or hospital experience preferred.
- You are tech savvy, with intermediate Microsoft Office skills to include Excel, PowerPoint, Outlook, and Word.
- You have demonstrated proficiency with techniques and principles of auditing.
- You can use and effectively present information in one-on one and small group situations on video conferencing systems (i.e., Cisco WebEx, Microsoft Teams, etc.), to include education providers or provider groups
- You have EMR (electronic medical records) experience, that is helpful (EPIC, Cerner, Meditech, MEDHOST, etc.)
- You are well organized with effective time management skills and comfortable working in a production environment.
SCP Health and its affiliated companies (collectively, “SCP Health”) require applicants for specific positions, such as those onsite at a client company/healthcare facility or affiliate to be vaccinated against COVID-19 as a condition of employment, except where prohibited by state or local law. To demonstrate compliance with SCP Health’s vaccination policy, proof of COVID-19 vaccination status will be requested upon a conditional offer of employment for onsite positions at a client company/healthcare facility. SCP health will consider religious and/or medical/disability accommodation and other legally required exemption request as required by applicable law.
To learn more about SCP Health, please visit:
www.scp-health.com
Join our social circle:
SCP Health is an Equal Opportunity Employer.
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