CLINICAL QUALITY DATA ANALYST

Eva Care Management Consultancy, Inc; Makati; On-site; PHP 335,000 - 502,000; Full time

Benefits offered by this job

Competitive Salary Package

Annual Performance Bonus

Opportunity for training and work rel.

2 Free Duty meals

Company Subsidized Lodging

HMO

Vacation and Sick Leave credits up to

Job summary

Eva Care Management Consultancy, Inc. is seeking a Registered Nurse with at least 1 year of clinical experience to join our team in Makati. The role involves analyzing resident health records, conducting audits, and ensuring compliance with HIPAA and health regulations.

On-site night shift work is required, with opportunities for training and US relocation consideration. You will generate and review clinical data, communicate with clinical leadership, and support billing workflows while

Qualifications

• Must be a Registered Nurse.
• With at least 1 year experience in a clinical setting.
• Ability to critically analyze Electronic Health Reports.
• Willing to work on site in Makati and night shift schedule.
• Can start ASAP.

Responsibilities

• Generate and analyze resident clinical data to detect defects, fraud, or non-compliance with health laws.
• Assess compliance with US federal and state health laws and standards.
• Identify inconsistencies in patient health information and document findings.
• Perform quantitative and qualitative analysis of medical records to detect deficiencies.
• Prepare detailed audit reports on findings.
• Submit compliance reports to relevant parties promptly.
• Communicate with CQDA team, administrators, and IT to verify data.
• Maintain confidentiality and security of resident health information.
• Assist billing and collection processes while observing HIPAA.
• Handle day-to-day administrative tasks and maintain data files.

Skills

Registered Nurse

NCLEX passer

Clinical experience

Critical thinking

Job description

Job Requirements:

• Must be a Registered Nurse. NCLEX Passer is an advantage but not required

• With at least 1 year experience in clinical setting

• Ability to critically analyze Electronic Health Reports

• Willing to work on site in Makati and nigh shift schedule.

• Can start ASAP.

Major Duties and Responsibilities:

1. Generate and analyze resident clinical data to detect deficient controls, duplicated effort, fraud, or non-compliance with laws, regulations, and management policies.

a. Use relevant information and individual judgment to determine whether events or processes comply with US Federal and state health laws, regulations, or standards.

b. Identify inconsistencies in patient health information by categorizing, estimating, recognizing differences or similarities, and detecting changes in circumstances or events.

b.1 Perform quantitative analysis, or review of prescribed areas of the medical records to identify the obvious and routine omissions and specific deficiencies in recording

b.2 Perform qualitative analysis, the review of the content of the medical record entries for inconsistencies and omissions, which may signify that the medical record is inaccurate or incomplete

b.2a. identify patterns of poor documentation practices

b.2b. identify potentially compensable events

2. Conduct routine audits for accuracy of coding and sufficiency of associated provider documentation to maintain best practice compliance standards.

a. Conduct off site pre or post charge audits on patient accounts to determine accuracy of coding

3. Prepare detailed reports on audit findings.

4. Submit accurate compliance reports to necessary parties in a timely manner.

5. Effectively communicate to provide information, raise and address concerns, inquire, verify data with MDS Coordinator, facility administrator, Director of Nursing, medical record designee, co-member of the CQDA Department t, IT Department and other members of the clinical team through phone, written form and e-mail.

6. Document and maintain compliance records and logs.

7. Perform day-to-day administrative tasks such as maintaining data files and processing paperwork.

8. Ensure confidentiality and security of clinical and resident health information at all times.

9. Coordinate with the financial team and assist in generating and providing information necessary for billing and collection process while strictly observing HIPAA law.

10. Other related duties and responsibilities that may become necessary or as directed by CQDA Department Head.

We Offer:

• Competitive Salary Package

• Annual Performance Bonus

• Opportunity for training and work relocation in US

• 2 Free Duty meals

• Company Subsidized Lodging

• HMO

• Vacation and Sick Leave credits and accrual up to 15 days. Cash – out of leave credits anytime within the year