QI Reviewer- Nurse Practitioner or Physician Assistant-Remote
Matrix Medical Network
2021-11-05T19:21:40Z
Scottsdale
Arizona
United States
Healthcare - Nursing
(No Timezone Provided)
Responsibilities
About the Position:
Type: Full Time
Compensation: Base + year's of experience
Location: Primary location is 9201 E. Mountain View, Road, Scottsdale, AZ 85258. Position is remote.
Hours: Days, evenings and some weekend hours
Benefits Offered to include: Medical, Dental, Vision, 401K with company matching, and eligible for tuition discount to name a few.
The QI Reviewer participates as a member of the Matrix Quality Improvement Team. The goal of QI Team is to monitor and improve the quality of the Comprehensive Health Assessments (CHA) performed by Matrix providers in the field for our customers. The responsibilities of this position include: medical review and evaluation of the CHA document for information consistency and documentation omissions; written reports of review findings; communication with assessment providers; and the development of education materials.
RESPONSIBILITIES:
Performs comprehensive medical reviews of Comprehensive Health Assessments performed by Matrix providers in the home or nursing care facility. Reviews the CHA for documentation completeness. Ensures that all medical diagnoses in the CHA are supported. Identifies conflicting information in the CHA documentation. Communicates results of CHA reviews with the assessment providers and clinical managers. Documents evaluations summarizing findings of CHA reviews. Produces educational material as needed for provider reference and use. Works collaboratively with other members of the QI team, the medical director, the medical coding team and the CHA processing team. Acts as a resource for the medical coders and other staff. Participates in all mandatory compliance and other training programs, seeks guidance for compliance-related concerns and adheres to all applicable laws, regulations and Matrix Medical Network policies and procedures . Ensures that contact center calls (live and pre-recorded) are adhered to by monitoring and providing consistent feedback for continuous improvement for all agents Daily coaching of all monitor calls with a written recap to the associate and Operations Leaders Provide constant and reliable verbal feedback to daily interactions, execution of processes or delivery of initiatives to the Manager of Quality Support Be an active participant of QO model Responsible for creating, providing and supporting a work environment focused on coaching, mentoring, and driving processes designed to assist agents in achieving their full potential. Supports new hires through the nesting phase to drive performance by consistent motivation, coaching and sharing best practice Conduct reverse Y cording with associate when appropriate. Document daily and provide weekly recaps to identify areas of opportunities for the Contact Center through observations and actions.
Participate in strategies to provide daily/frequent motivation to the Contact Center agents aligned to objectives being driven. Interprets, analyzes data and monitor call behaviors including ACW, call times, breaks and long/short calls in order to assist OL in coaching to these behaviors using Five9, Tableau, SharePoint, Access Databases and other reporting tools. Ensures compliance of department policies and procedures as well as all forms of communication within the contact center. Participates in assessment of training needs and activities to improve performance. Work with the Operations Leaders, Clinical Support Services and Training Associate to conducts trainings and initiatives as needed on quality topics Remain current on departmental updates by reading and understanding documentation provided through e-mail, team meetings, center handouts and training. Use quality monitoring data to compile and track and report performance at the team and individual level. Evaluates results in aggregate to identify learning deficits and opportunities for performance improvement activities. Provides actionable data to various internal support groups as needed. Reviews documentation and reports compliance with Matrix standards. Operates various office equipment, including but not limited to telephones and computers OB/IB dialing based on Contact Center needs Performs other duties as assigned
Qualifications
Must Haves:
Minimum of 9 months of Matrix Contact Center experience; Health Care definitely a plus. Must have a proven track record of providing excellent Member experience, while balancing the need for attention to details. Must have excellent verbal and written communication skills, with good command of the English language, in addition to strong interpersonal skills. Must be comfortable speaking in small or larger audiences when providing feedback. Minimum 3 years clinical experience as a Clinical Nurse Specialist, Licensed Nurse Practitioner, Physician Assistant or MD/DO, RN which includes performing physical assessments. Have experience managing chronic diseases. Compliant with appropriate National Certification. Be able to create/edit documents in word processing and enter data in spreadsheet programs. Effective written communication skills including but not limited to writing reports and correspondence. Effective verbal communication skills including but not limited to speaking effectively to providers and other staff . Ability to work independently. Demonstrated ability to read and correctly interpret business related documents. Demonstrated ability to meet deadlines. Demonstrated successful experience working in an environment of change. Knowledge and understanding of Medicare reimbursement preferable. Knowledge and understanding of ICD10 coding preferable. Prior experience in a Quality Improvement or Quality Assurance Program desirable. Excellent coaching and development skills High level of attention to detail, accuracy and thoroughness Demonstrated organizational and time management skills Solid interpersonal and customer service skills for effective communication with all employee levels Strong Customer Focus Must be innovated and flexible Excellent organizational and analytical skills Demonstrated problem-solving skills Demonstrated ability to work independently and to maintain confidential information Must be flexible to work within Contact Center hours High School Diploma or a GED equivalent combination of education and related experience. Associate Degree preferred. Supervisory Responsibility : No supervisory responsibilities.
Travel requirements : Does not apply
Work Conditions: General office / remote work environment.
Our Culture:
We have a clear vision of where we are going, and we are guided by core values that embody our organization and our culture. We emphasizes innovation and growth, and you will be given the opportunities and tools to develop personally and professionally. We encourage and celebrate collaboration. We have a deep commitment to positively impact the communities in which we work and to make a difference in the lives of who we serve. As a clinical organization, we support vaccinations because we care about the health and safety of our colleagues and those we serve. Moreover, our clients are increasingly expecting us to be vaccinated due to the vulnerability of those we serve. As such, Matrix Medical Network requires that all team members are fully vaccinated against COVID-19, unless they are eligible for a specific exemption. Matrix Medical Network is an Equal Employment Opportunity Employer. It is the policy of Matrix to provide equal employment opportunities without regard to race, color, religion, sex, gender identity or expression, pregnancy, age, national origin, age, disability, marital status, veteran status, sexual orientation, genetic information or any other protected characteristic under applicable law. It is also the policy of Matrix that qualified individuals with disabilities receive equal opportunity in regard to job application procedures, hiring, and all aspects of the employment process. Matrix is committed to the full inclusion of all qualified individuals. Consistent with the Americans with Disabilities Act (ADA) and applicable state and local laws, it is the policy of Matrix to provide reasonable accommodation when requested by a qualified applicant or employee with a disability, unless such accommodation would cause an undue hardship. If reasonable accommodation is needed to participate in the job application or interview process, pre-employment testing, to otherwise participate in the selection process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact [email protected].
QI Reviewer- Nurse Practitioner or Physician Assistant-Remote
Responsibilities
About the Position:
Type: Full Time
Compensation: Base + year's of experience
Location: Primary location is 9201 E. Mountain View, Road, Scottsdale, AZ 85258. Position is remote.
Hours: Days, evenings and some weekend hours
Benefits Offered to include: Medical, Dental, Vision, 401K with company matching, and eligible for tuition discount to name a few.
The QI Reviewer participates as a member of the Matrix Quality Improvement Team. The goal of QI Team is to monitor and improve the quality of the Comprehensive Health Assessments (CHA) performed by Matrix providers in the field for our customers. The responsibilities of this position include: medical review and evaluation of the CHA document for information consistency and documentation omissions; written reports of review findings; communication with assessment providers; and the development of education materials.
RESPONSIBILITIES:
Performs comprehensive medical reviews of Comprehensive Health Assessments performed by Matrix providers in the home or nursing care facility. Reviews the CHA for documentation completeness. Ensures that all medical diagnoses in the CHA are supported. Identifies conflicting information in the CHA documentation. Communicates results of CHA reviews with the assessment providers and clinical managers. Documents evaluations summarizing findings of CHA reviews. Produces educational material as needed for provider reference and use. Works collaboratively with other members of the QI team, the medical director, the medical coding team and the CHA processing team. Acts as a resource for the medical coders and other staff. Participates in all mandatory compliance and other training programs, seeks guidance for compliance-related concerns and adheres to all applicable laws, regulations and Matrix Medical Network policies and procedures . Ensures that contact center calls (live and pre-recorded) are adhered to by monitoring and providing consistent feedback for continuous improvement for all agents Daily coaching of all monitor calls with a written recap to the associate and Operations Leaders Provide constant and reliable verbal feedback to daily interactions, execution of processes or delivery of initiatives to the Manager of Quality Support Be an active participant of QO model Responsible for creating, providing and supporting a work environment focused on coaching, mentoring, and driving processes designed to assist agents in achieving their full potential. Supports new hires through the nesting phase to drive performance by consistent motivation, coaching and sharing best practice Conduct reverse Y cording with associate when appropriate. Document daily and provide weekly recaps to identify areas of opportunities for the Contact Center through observations and actions.
Participate in strategies to provide daily/frequent motivation to the Contact Center agents aligned to objectives being driven. Interprets, analyzes data and monitor call behaviors including ACW, call times, breaks and long/short calls in order to assist OL in coaching to these behaviors using Five9, Tableau, SharePoint, Access Databases and other reporting tools. Ensures compliance of department policies and procedures as well as all forms of communication within the contact center. Participates in assessment of training needs and activities to improve performance. Work with the Operations Leaders, Clinical Support Services and Training Associate to conducts trainings and initiatives as needed on quality topics Remain current on departmental updates by reading and understanding documentation provided through e-mail, team meetings, center handouts and training. Use quality monitoring data to compile and track and report performance at the team and individual level. Evaluates results in aggregate to identify learning deficits and opportunities for performance improvement activities. Provides actionable data to various internal support groups as needed. Reviews documentation and reports compliance with Matrix standards. Operates various office equipment, including but not limited to telephones and computers OB/IB dialing based on Contact Center needs Performs other duties as assigned
Qualifications
Must Haves:
Minimum of 9 months of Matrix Contact Center experience; Health Care definitely a plus. Must have a proven track record of providing excellent Member experience, while balancing the need for attention to details. Must have excellent verbal and written communication skills, with good command of the English language, in addition to strong interpersonal skills. Must be comfortable speaking in small or larger audiences when providing feedback. Minimum 3 years clinical experience as a Clinical Nurse Specialist, Licensed Nurse Practitioner, Physician Assistant or MD/DO, RN which includes performing physical assessments. Have experience managing chronic diseases. Compliant with appropriate National Certification. Be able to create/edit documents in word processing and enter data in spreadsheet programs. Effective written communication skills including but not limited to writing reports and correspondence. Effective verbal communication skills including but not limited to speaking effectively to providers and other staff . Ability to work independently. Demonstrated ability to read and correctly interpret business related documents. Demonstrated ability to meet deadlines. Demonstrated successful experience working in an environment of change. Knowledge and understanding of Medicare reimbursement preferable. Knowledge and understanding of ICD10 coding preferable. Prior experience in a Quality Improvement or Quality Assurance Program desirable. Excellent coaching and development skills High level of attention to detail, accuracy and thoroughness Demonstrated organizational and time management skills Solid interpersonal and customer service skills for effective communication with all employee levels Strong Customer Focus Must be innovated and flexible Excellent organizational and analytical skills Demonstrated problem-solving skills Demonstrated ability to work independently and to maintain confidential information Must be flexible to work within Contact Center hours High School Diploma or a GED equivalent combination of education and related experience. Associate Degree preferred. Supervisory Responsibility : No supervisory responsibilities.
Travel requirements : Does not apply
Work Conditions: General office / remote work environment.
Our Culture:
We have a clear vision of where we are going, and we are guided by core values that embody our organization and our culture. We emphasizes innovation and growth, and you will be given the opportunities and tools to develop personally and professionally. We encourage and celebrate collaboration. We have a deep commitment to positively impact the communities in which we work and to make a difference in the lives of who we serve. As a clinical organization, we support vaccinations because we care about the health and safety of our colleagues and those we serve. Moreover, our clients are increasingly expecting us to be vaccinated due to the vulnerability of those we serve. As such, Matrix Medical Network requires that all team members are fully vaccinated against COVID-19, unless they are eligible for a specific exemption. Matrix Medical Network is an Equal Employment Opportunity Employer. It is the policy of Matrix to provide equal employment opportunities without regard to race, color, religion, sex, gender identity or expression, pregnancy, age, national origin, age, disability, marital status, veteran status, sexual orientation, genetic information or any other protected characteristic under applicable law. It is also the policy of Matrix that qualified individuals with disabilities receive equal opportunity in regard to job application procedures, hiring, and all aspects of the employment process. Matrix is committed to the full inclusion of all qualified individuals. Consistent with the Americans with Disabilities Act (ADA) and applicable state and local laws, it is the policy of Matrix to provide reasonable accommodation when requested by a qualified applicant or employee with a disability, unless such accommodation would cause an undue hardship. If reasonable accommodation is needed to participate in the job application or interview process, pre-employment testing, to otherwise participate in the selection process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact [email protected].