As a part of the Tenet and Catholic Health Initiatives family, Conifer Health Solutions is a leading healthcare business process management services provider working to improve operational performance for more than 600 clients so they can support financial improvement, enhance the patient experience, and drive value-based performance. We empower healthcare decision makers—hospitals, health systems, physicians, self-insured employers, and payers—to better connect every point of care and wellness management. Are you ready to be part of our solutions? Welcome to the company that gives you the resources and incentives to redefine healthcare services, with a competitive benefits package and leadership to take your career to the next step!
Conifer Health Solutions is currently hiring!
This position integrates fully with the clinical services department to monitor the quality and accuracy of reviewed cases, outbound calls placed to hospital personnel, communications with other clinical service staff, and compliance with protocol changes as required due to technological and/or process changes. Will perform reviews in real time and provides immediate feedback to clinical specialist when errors are discovered. Identifies quality improvement opportunities and presents to Manager/Team Leaders for consideration and approval. Promote, by example, a customer-centric, professional management culture. Forge enduring, positive relationships with team leaders and team members. Will demonstrate the skills needed to see initiative through to a successful, timely and effective end.
ESSENTIAL DUTIES AND RESPONSIBILITIES
Include the following. Others may be assigned.
Develops and deploys daily audits to assess the quality and accuracy of the Clinical Support Specialists.
Uses audits to identify trends and training opportunities.
Organizes information and individual audit results sufficient to support management in annual performance evaluations and monthly bonus program.
Assures that clinical information is accurate and current. Communicates any system related issues to the appropriate individuals for resolution.
Assumes training responsibilities, including the conducting of certified training classes and acting as informational and educational resource to new hires on shift. Monitors the progress of trainees, ensuring the quality and accuracy of reviews performed.
Provide interim Team Leader or Representative coverage during absence of staff due to vacation, extended illness, vacancy, etc.
KNOWLEDGE, SKILLS, ABILITIES
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Intermediate-to-Advanced Excel and Word skills highly desirable.
Broad understanding of Quality Assurance and Quality Improvement fundamentals and methodologies.
Business skills and maturity sufficient to maintain objectivity and fairness in analyzing audit results.
Business skills and maturity sufficient to enlist the cooperation and respect of the colleagues being audited.
Clear, effective and accurate verbal and written communication skills required.
Organizational and prioritization skills sufficient to effectively manage multiple, concurrent initiatives in a deadline-driven environment required.
Self-discipline sufficient to work with minimal supervision required.
Ability to embrace corporate philosophy/principles and comply with Corporate Ethics guidelines required.
Handling of all audit results with discretion and confidentiality required.
Handling of all PHI (Protected Health Information) and Patient Identifiable Data with discretion and confidentiality required.
EDUCATION / EXPERIENCE
Include minimum education, technical training, and/or experience required to perform the job.
Conifer - Lincoln, NE
8 Hour Day