Clinical Analyst - Greensburg/Johnstown

Senior LIFE PA; Johnstown (Cambria County); Híbrido; USD 65 000 - 90 000; Tempo integral

Resumo da oferta

PACE Consulting Solutions is seeking a Clinical Analyst for a full-time role in Greensburg and Johnstown, PA. The analyst will perform medical record audits, ensuring documentation is complete, compliant, and accurate, while advising staff and providers to meet regulatory requirements.

The role requires experience in healthcare management and regulatory oversight, with on-site responsibilities and ongoing quality improvement initiatives to support Senior LIFE program operations.

Qualificações

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

Responsabilidades

• Review documentation to assure compliance with 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 quality initiatives with measurable goals and data-driven outcomes.
• Provide site visits including real-time auditing of center activities and member care.
• Oversee mock audits and remediation processes to gauge readiness and drive improvements.

Conhecimentos

Regulatory compliance

Healthcare management

Audit support

Formação académica

RN license (preferred)

Descrição da oferta de emprego

Overview

PACE Consulting Solutions is currently seeking a Clinical Analyst for a full time role

Greensburg, PA

Johnstown, PA

The Clinical Analyst performs medical record audit/validation processes to ensure that documentation rendered is complete, compliant, and accurate. Candidates must be well versed in all policies, procedures, best practices, and regulatory requirements. This position will provide real time feedback to management, clinical and non-clinical staff, and contracted providers to ensure compliance with all regulatory requirements.

Requirements

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

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
• Provide oversight of real time auditing completed by program staff to ensure compliance
• 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

EOE