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Form of work
SalaryPOSITION: Clinical Quality Specialist
FULL-TIME/PART-TIME: Full time
LOCATION: Remote
Circadian Health offers bundled heart & rhythm, respiratory, endocrinology and sleep health solutions to risk bearing entities. Our network of cardiologists, pulmonologists, endocrinologists and boarded sleep doctors provide on demand virtual care, from initial visit, to diagnosis, to prescribing and ongoing care. Our bundles include access to an array of in-home diagnostic testing and sleep aid products and ventilation equipment to help identify and treat emerging heart and respiratory diseases.
The primary responsibility of this role will be to conduct chart audits on both new and existing providers, ensuring compliance with established standards and protocols. Additionally, the Clinical Quality Specialist will play a crucial role in managing the awareness and tracking of issues identified during audits, serving as the liaison and escalation point to bring concerns to the Peer Review committee.
QUALIFICATIONS
QUALIFICATIONS
- Bachelor's degree in healthcare administration, nursing, or a related field
- Minimum of 3 years of experience in healthcare quality management, clinical auditing, or a similar role.
- Strong knowledge of clinical documentation standards, regulatory requirements, and quality assurance principles.
- Experience with conducting chart audits and analyzing complex medical records.
- Excellent communication and interpersonal skills, with the ability to effectively interact with providers and other healthcare professionals.
- Demonstrated ability to work independently and collaboratively in a fast-paced environment.
- Proficiency in Microsoft Office Suite, Google Suite, and electronic health record (EHR) systems.
Preferred Education
- Master's degree in healthcare administration, nursing, or a related field
Preferred Experience
- Certification in healthcare quality (e.g., CPHQ) is a plus.
- Excellent attention to detail and project management skills.
- Excellent written/oral communication skills required. Must be able to work effectively with diverse groups of people.
Physical Demands
- Requires normal visual acuity and hearing.
- Typically, employees sit comfortably to do their work, interspersed by brief periods of standing, walking, bending, carrying papers and books, and extensive periods requiring the use of computer terminals to accomplish work objectives.
- Required to sit and use their hands and fingers to handle or feel and manipulate keys on a keyboard.
- Additional skills may be required to perform additional task(s) specific to work location, department or line of business.
Working Conditions
- Predominantly operates in an office environment. Some work (less than 5%) requires moving and lifting of heavy networking equipment.
DUTIES AND ESSENTIAL FUNCTIONS
Each Employee consistently demonstrates the following essential functions:
- Conduct comprehensive chart audits on new and existing providers to assess compliance with clinical documentation standards, regulatory requirements, and organizational policies.
- Identify areas for improvement in documentation practices and provide constructive feedback to providers to promote accuracy and completeness.
- Collaborate with internal stakeholders to develop and implement corrective action plans to address deficiencies identified during audits.
- Maintain detailed records of audit findings, corrective actions, and follow-up activities to ensure accountability and compliance.
- Serve as the primary point of contact for providers regarding questions or concerns related to clinical documentation requirements.
- Actively participate in the peer review committee meetings to present audit findings, discuss trends, and escalate unresolved issues for further review and action.
- Facilitate communication between the peer review committee and relevant departments to ensure timely resolution of identified issues.
- Stay abreast of changes in regulatory requirements and industry best practices related to clinical documentation and quality assurance.
- Assist in the development and delivery of educational programs and training materials to support ongoing provider education and quality improvement initiatives.
- Collaborate with cross-functional teams to streamline processes and implement innovative solutions to enhance the overall quality of care delivery.
- Attends and participates in departmental meetings.
- Attends seminars and training sessions necessary to maintain appropriate level of professional competence
- Ensures all department compliance guidelines are met
- Attends all meetings, in-services training, or continuing education as delegated by the supervisor
- Provides customer focused interactions
- Performs all duties necessary for the department as per department policies and procedures
- Performs other duties and responsibilities as delegated by the supervisor within the scope of practice and the responsibilities in the department
Reasonable accommodations may be made to accommodate individuals with disabilities to perform the basic functions of the position without compromising client care. Circadian is an Equal Opportunity/Affirmative Action Employer and is committed to providing a drug-free workplace. We are an Equal-Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state, or local protected class.
