Claims Quality Audit Director jobs in Goose Creek, SC

Responsible for the strategic leadership of quality and accreditation at Roper Saint Francis Healthcare. This includes performance improvement, clinical quality and operational effectiveness (project management office) and quality informatics (payer quality reporting, credentialing, maintenance of registries, development of scorecards, and data analytics). Responsible for the development of the overall quality structure and in order to provide coordinated leadership and support to achieve system quality and safety goals. Creates alignment to ensure clear linkages between goals and strategy and helps integrate quality into daily work responsibilities.

Minimum Qualifications:

Education Required: External candidates - master's degree in business, administration, public health, nursing, health administration or related fields. Internal candidates - if candidate only has a bachelor's degree, the candidate must enroll in a master's program within one year of hire and complete the program within 5 years of hire.

Experience: Five years' experience in quality, safety, project management, and/or health care administration required.

Licensure/Certification:Current SC licensed practitioner preferred; Certification in health care quality, patient safety, or related regulatory entity preferred. If a licensed RN, nursing specialty certification required within 6 months of position start (applicable certifications include approved ANCC clinical specialty or nursing leadership certifications).

Labor, Licensing and Regulation (LLR) Registered Nurse only. http://verify.llronline.com/LicLookup/LookupMain.aspx

Knowledge/Skills: Quality principles and performance improvement methods, project planning/management, clinical database management and reporting methods, CMS, Joint Commission and other regulatory standards, mandated quality initiatives from government and other accrediting or licensing bodies. Excellent interpersonal and communication skills: individual, team/group, negotiation, conflict management, planning, and presentation to groups as large as 200 . Leadership skills: budget planning and execution, daily operations, personnel management, leadership of department staff as well as other members of organizational staff at every level. Computer skills with typical office software; ability to use complex clinical databases.

Contacts: Vice Presidents, Board Members, physicians, patients, patient family members, councils, all staff within the hospital facilities, and other support staff throughout the system. DHEC, The Joint Commission (TJC) and other regulatory bodies where applicable.