Clinical Analyst - Greensburg/Johnstown

Responsibilities

• Review documentation to assure compliance with all Medicare, Medicaid, and federal regulations
• Identify areas of improvement, write plans of correction, and provide staff education
• Provide on-site support during regulatory audits
• Build trusting relationships with Senior LIFE program staff through open communication and education
• Monitor development and implementation of all quality initiatives to ensure they are data driven, have measurable goals, and are aimed at maintaining or improving care based on outcome measures
• Provide site visits to include real time auditing of center activities and member care
• Schedule, facilitate and participate in mock audits of programs to gauge audit readiness and to identify areas for improvement
• Provide mock audit reports and oversee remediation process

Requirements

• RN license is preferred
• Minimum of 3 years experience in health care management and regulatory oversight
• Valid PA driver’s license