Clinical Quality Analyst Sr (Rhrp)

Job Summary:

Responsible for the analysis of examination reports, quality reviews, and data to ensure clinical compliance. Provides analysis for proper utilization of KMEP to ensure timely and accurate completion of medical reports.

Essential Duties and Responsibilities:

• Interact with field personnel and supervisors
• Ensure compliance and understanding of quality requirements
• Analyze data and observations and write result summaries to validate deviations from existing standards
• Manage special projects and make recommendations as appropriate
• Compile strategic information and develop reports to monitor quality effectiveness
• Conduct internal quality assurance of providers (medical professionals)
• Document quality issues and performance measures for management review
• Mentor and train team members and provide resource support with daily tasks
• Perform other duties and responsibilities as assigned
• Conduct conference calls and refresher training with providers
• Respond to compliance issues in the absence of the Director of Compliance
• Review, analyze, and implement processes and report trends to promote customer satisfaction
• Recommend modifications to existing standards, methods, or procedures

Competencies:

• Demonstrated data gathering and reporting skills
• Proficient with MS Word, Excel, Access, and PowerPoint
• Strong medical background
• Excellent computer and presentation skills
• Strong business development, organization, analytical and problem-solving skills

Education and/or Experience: (includes certificate & licenses)

• Experience working as a Quality Analyst at QTC, with the VA, or a similar agency
• Experience in performing Quality Reviews in a healthcare environment
• Must be able to successfully pass National Agency Check with Inquiries (NACI) background investigation

This job description supersedes all prior job descriptions and is intended to describe the general content and essential requirements for the position listed above. It is not to be construed as an exhaustive statement of requirements, duties and responsibilities. Management reserves the right to add or change the duties of this position as required at any time.

QTC Management Inc. is a VEVRAA Federal contractor and an Equal Opportunity Employer. The company has an ongoing commitment to affirmative action and the creation of a workplace free of discrimination, harassment and retaliation. The company recruits, hires, trains, and promotes individuals in all job titles without regard to race, color, creed, religion, ancestry, national origin, age, sex, sexual orientation, people with disabilities protected under law, and protected veteran status.

Experience

Required

• 6 - 10 years: Relevant professional experience - Quality Analyst at QTC, with the VA, or a similar agency)

Education

Required

• Bachelors or better

Skills

Preferred

• Executing Multiple Tasks
• Computer Literacy
• Team Player
• Medical Terminology
• Written Communication
• Verbal Communication
• MS Office

Behaviors

Preferred

• Detail Oriented: Capable of carrying out a given task with all details necessary to get the task done well
• Dedicated: Devoted to a task or purpose with loyalty or integrity
• Team Player: Works well as a member of a group

Motivations

Preferred

• Work-Life Balance: Inspired to perform well by having ample time to pursue work and interests outside of work
• Growth Opportunities: Inspired to perform well by the chance to take on more responsibility
• Goal Completion: Inspired to perform well by the completion of tasks
• Self-Starter: Inspired to perform without outside help

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c)