Quality Improvement Manager Jobs

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Data Management

Under the general direction of the Revenue Cycle Management (RCM) Department Leadership, the Quality Improvement Manager (QIM) plans, organizes, and manages the activities that ensure the quality of RCM Operations and over-all quality/effectiveness of the Golden Hour RCM Standard Operating Procedures (SOP) at the Golden Hour RCM Office in San Diego, or other locations as the department grows and expands. The QIM may plan and provide a variety of training sessions, perform a variety of administrative work functions associated with ensuring appropriate and standardized utilization of SOPs; serves a primary role in the completion of the department’s coaching and disciplinary actions including Performance Improvement Plans. QIM will require some travel, extremely communicative with many levels of leadership, and exceedingly analytical.

DISTINGUISHING CHARACTERISTICS

This is a leadership position with primary responsibility for the administration of the quality improvement of the RCM Department Staff. This position requires strong management and communication skills as well as problem solving skills and the ability to participate effectively in decision-making processes.

Duties / Knowledge & Skills

• Provides training for staff both in group training sessions and individually as needed.
• Manages Golden Hour’s Certified Coding (CPC and CAC) Continuous Education Unit (CEU) Program. Chooses training offered by MLN, WPS, NAAC,etc that are appropriate for the ambulance industry.
• Tracks and maintains reports regarding staff production and provides information about staff performance to appropriate management and leadership.
• Recommends changes in policies and procedures and Standard Operating Procedures as necessary.
• Oversees the training and performance of outsourced staff (work from home, temporary, and/or offshore)
• Oversees suspected breach process and ensures timely analysis, evaluation, and completion of documentation and any follow up training.
• Prepares comprehensive reports related to RCM Operations and Activities.
• Suggests and implements improvements to processes for efficiency.
• When appropriate, meets with staff members to inquire about issues, training required, or obstacles that impede performance and production.
• Facilitates and participates with department staff in utilization review and quality improvement meetings.
• Work closely with Human Resources and Compliance Departments to ensure staff are following guidelines from the Employee Handbook and our various SOPs.
• Evaluates attendance requirements including, but not limited to, tardies, unplanned events, leave of absences, etc.
• Helps perform Continuous Quality Improvement (CQI) reports on individual staff members.
• Other duties as assigned

Minimum Qualifications & Requirements

Knowledge of:

• Basic mathematics and basic computer applications and techniques
• Basic training and employee development principles and practices
• Quality review/quality assessment principles, practices, methods and techniques
• Pertinent laws and regulations regarding health and social service programs, including guidelines pertaining to reimbursement of health care services

Ability to:

• Operate standard office equipment, utilize various software programs relevant to the responsibilities of the position
• Communicate effectively both orally and in writing
• Maintain confidential information to safeguard such information and only use it or disclose it as expressly authorized or specifically required during the course of performing specific job duties.
• Travel occasionally – estimated 10-15%
• Create, Review, and interpret Standard Operating Procedures and Process Documentation.
• Prepare concise, logical oral and written reports and explain policies, procedures and recommendations
• Collect, interpret and evaluate data
• Ascertain facts through examination of transaction histories
• Utilize Salesforce for record keeping and documentation of task progress
• Prepare and maintain accurate records

Golden Hour appreciates and values diversity. We are an equal opportunity employer and do not discriminate in hiring or employment on the basis of race, color, religion, national origin, citizenship, gender, gender identity, genetic information, marital status, sexual orientation, age, disability, veteran status, or any other characteristic protected by federal, state, or local law.