Willoughby Area Jobs

Ashtabula , OH

Director of Ambulatory Quality

Willoughby Area Jobs
Ashtabula, OH Full-time
Posted on March 3, 2019
Directory of Ambulatory Quality SPECIFIC EDUCATIONAL AND SKILL COMPETENCIES REQUIRED FOR THIS POSITION: ? One year nurse auditor (RN) experience or Case Management Certification (CCM) preferred. ? Advanced degree with training or experience in auditing of clinical records preferred. A minimum of three years nursing experience required. ? This position requires good knowledge of government payer guidelines, third party administrators, appeals, and claims. ? Good clinical knowledge is needed to effectively interact with all levels of health care providers. License/Certifications required: RN, BSN, and Master's is preferred. ? Ability to perform and respond to government and commercial payer clinical audit reviews and appeals ? Sound clinical knowledge base of CMS and commercial payer guidelines ? Knowledge of clinical reviewing, data collection & analysis, and generating reports