QA Analyst

QA ANALYST-HEALTH CARE NEEDED IN SAN FRANCISCO - WE WANT TO TALK TO YOU!

As a global business and technology consulting services leader, Enclipse focuses on delivering tangible solutions. 

By employing a team committed to questioning and challenging the status quo, Enclipse has established a culture that encourages independent thought, innovation, and flexibility.

If you join Enclipse, you can expand your technology platform while working for the Nation's most dynamic Health Care Leader.

WE PROVIDE:

- Class A Benefits  that Start ASAP
- The Personal Touch -- You deserve it, We deliver it!

Contract Terms: W2

BB37047

San Francisco, CA 94115

3months +

HOURS: DAYS

EXPERIENCE REQUIREMENTS: RECENT EXPERIENCE AS A QUALITY ANALYST, OR SIMILAR POSITION, IN HEALTH CARE PREFERRED

WORK ENVIRONMENT: OFFICE

SCOPE OF THE PROJECT: 3 MONTHS

Top 3 skills needed to succeed in this position:
1. Knowledge of medical terminology
2. Skills in medical record reading & review
3. Generation of computerized reports and maintenance of all data files

Top 5 daily responsibilities:
1. Data collection
2. Organizing and tracking of MD performance evaluations
3. Peer review/department review process support
4. Communication with physicians
5. Data entry

Who will the contractor be reporting to? Quality Director

Top 3 personality characteristics:
1. Attention to detail
2. Self motivated
3. Personable

Educational Requirements:
1. High School diploma
2. Computer experience
3. Some college level courses preferred

Medical Facility? yes

Position Summary:
Assists clinical support services and hospital ambulatory and health plan committees with patient care review and reporting requirements. Ensures accurate data collection, organization and tracking of medical staff departmental chart reviews, generation of computerized reports and maintenance of all data files.

Duties:
Conducts concurrent and retrospective clinical studies by performing review using screening criteria as prescribed by the medical staff. Performs variance screening and tracking by reviewing Clinical Pathway documentation to monitor quality of care issues. Aggregates data and refers all cases not meeting established criteria to Departmental Quality Assurance. Enters QA/RM/UM variances from care paths, screening indicators, utilization focused studies and Medicare admission necessity and continued stay reviews into the department computer database. Prepares statistical reports based on information retrieved from MIDAS, EZ-QA, PARRS, and/or CABS/ADT systems and manual record review and data aggregation. Enters unusual occurrence and other information into the department database. Creates and runs reports for departments and the Committees. Prepares worksheets, distributes charts, and completes applicable portions of the physician peer review forms and monitors their completion by the medical staff. Maintains confidentiality of all data. Organizes and maintains the data to assure integrity and reliability for future reporting.

Consistently supports compliance and the Principles of Responsibility (CLIENT's code of conduct) by maintaining confidentiality, protecting the assets of the organization, acting with ethics and integrity, reporting non-compliance, and adhering to applicable Federal and State laws and regulations, accreditation and licensure requirements, and CLIENT policies and procedures.

In addition to defined technical requirements, accountable for consistently demonstrating service behaviors and principles defined by the Client Service Quality Credo, the CLIENT Mission as well as specific departmental/organizational initiatives. Also accountable for consistently demonstrating the knowledge, skills, abilities, and behaviors necessary to provide superior and culturally sensitive service to each other, to our members, and to purchasers, contracted providers and vendors.