Clinical Auditor at Inovalon (Bowie, MD)

Inovalon is a leading technology company that combines advanced cloud-based data analytics and data-driven intervention platforms to achieve meaningful insight and impact in clinical and quality outcomes, utilization, and financial performance across the healthcare landscape. Inovalon's unique achievement of value is delivered through the effective progression of Turning Data into Insight, and Insight into Action.

The Clinical Auditor /Coach is responsible for auditing medical records documented during the home assessment visit, facilitating inter-rater reliability sessions influencing remediation and sharing ideas for training to influence and improve performance of the employees performing in-home assessments. This role will provide specific guidance on improvement opportunities and provide specific remediation training on quality issues identified in review of a specific clinical resource's audit results.This role will support and further the organization in its goals for growth, competition, and financial strength by completing independent audits of the clinical documentation.

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• Performs audits of medical records to ensure that documentation is complete, consistent, accurate and timely accordingly to clinical protocols;
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• Compiles information and prepare reports for management;
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• Analyzes documentation completion data and submits recommendations to improve quality;
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• Identifies opportunities for data tracking and database enhancements and effective improvements;
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• Develops, documents and trains audit protocols based on clinical findings; this includes but is not limited to documenting the audit process; establishing performance thresholds; developing and updating tools and score cards;
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• Partners in conjunction with the clinical training team, assesses and identifies training needs, contributes to the training material development, and supports implementation;
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• Reviews the results of audits of medical records performed by the Clinical Auditor;
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• Provides specific one-on- one coaching on quality issues identified in review of the clinical resource's audit results;
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• Interfaces with the different sites and levels of care to provide coaching feedback and training based on clinical audit results;
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• Establish and facilitate routine communication and feedback mechanisms for delegated oversight of audit findings to clinical management. Additionally, utilize findings and trends to improve policies, procedures and associate comprehension via training;
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• Manage integration of information from multiple sources and competing priorities and maintain focus on organizational goals;
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• Evaluate information for integrity, accuracy, and appropriateness ensuring compliance with regulatory standards;
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• Identify issues, propose methodological solutions, thoroughly analyze information, and present findings with implications in a clear and direct manner; and
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• Prepares documentation tracking coaching efforts and results of coaching efforts.
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• Must be licensed and credentialed LPN or RN;
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• Minimum 2 years of experience as clinical auditor in a health care setting (health plan or clinical);
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• Leadership skills to influence the internal responses to audit results and remediation coaching;
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• Highly organized with demonstrated ability to review, audit, and analyze clinical documentation;
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• Direct knowledge and understanding of the HIPAA regulations/guidelines;
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• Ability to plan, and prioritize multiple activities with keen attention to details;
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• Consistently demonstrate excellent effective time management skills and critical thinking skills;
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• Proficiency in Microsoft Office (Word, Excel, Access, and PowerPoint), and the ability to understand statistical software, and match software with the type of information being analyzed; and
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• Excellent written, oral communication and interpersonal relationship building skills.
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Inovalon provides equal employment opportunities (EEO) to all employees and applicants for employment. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, or protected veteran status and will not be discriminated against on the basis of disability.

PI102934960

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