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12409 - QI Reviewer

Company: Matrix Medical Network
Location: Scottsdale
Posted on: September 8, 2020

Job Description:

Position: Quality Improvement Reviewer Reports To: Director, Coding and Quality Compliance Department: Quality Operations Status: Exempt Location: Scottsdale, AZ POSITION SUMMARY: The QI Reviewer participates as a member of the Matrix Quality Improvement Team. The goal of QI Team is to monitor and improve the quality of the Comprehensive Health Assessments (CHA) performed by Matrix providers in the field for our customers. The responsibilities of this position include: medical review and evaluation of the CHA document for information consistency and documentation omissions; written reports of review findings; communication with assessment providers; and the development of education materials. POSITION RESPONSIBILITIES: Performs comprehensive medical reviews of Comprehensive Health Assessments performed by Matrix providers in the home or nursing care facility. Reviews the CHA for documentation completeness. Ensures that all medical diagnoses in the CHA are supported. Identifies conflicting information in the CHA documentation. Communicates results of CHA reviews with the assessment providers and clinical managers. Documents evaluations summarizing findings of CHA reviews. Produces educational material as needed for provider reference and use. Works collaboratively with other members of the QI team, the medical director, the medical coding team and the CHA processing team. Acts as a resource for the medical coders and other staff. Participates in all mandatory compliance and other training programs, seeks guidance for compliance-related concerns and adheres to all applicable laws, regulations and Matrix Medical Network policies and procedures . Performs other assigned tasks and duties as necessary. POSITION REQUIREMENTS: Educational Requirements: Current license as a Nurse Practitioner, Physician Assistant, or Physician with MD or DO degree in the state in which you live. Nurse Practitioners and Physician Assistants must be Board certified in Adult, Family or Geriatric Medicine. Required Skills and Abilities: Minimum 3 years clinical experience as a Clinical Nurse Specialist, Licensed Nurse Practitioner, Physician Assistant or MD/DO which includes performing physical assessments. Have experience managing chronic diseases. Compliant with appropriate National Certification. Be able to create/edit documents in word processing and enter data in spreadsheet programs. Effective written communication skills including but not limited to writing reports and correspondence. Effective verbal communication skills including but not limited to speaking effectively to providers and other staff . Ability to work independently. Demonstrated ability to read and correctly interpret business related documents. Demonstrated ability to meet deadlines. Demonstrated successful experience working in an environment of change. Knowledge and understanding of Medicare reimbursement preferable. Knowledge and understanding of ICD10 coding preferable. Prior experience in a Quality Improvement or Quality Assurance Program desirable. Supervisory Responsibility: No supervisory responsibilities. Travel requirements: Occassional travel may be required. Work Conditions: General office / remote work environment. The preceding functions may not be comprehensive in scope regarding work performed by an employee assigned to this position classification. Management reserves the right to add, modify, change or rescind the work assignments of this position. Management also reserves the right to make reasonable accommodations so that a qualified employee(s) can perform the essential functions of the position.

Keywords: Matrix Medical Network, Scottsdale , 12409 - QI Reviewer, Other , Scottsdale, Arizona

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