Supports facility activities in the coordination and development of data collection and analysis techniques, primarily in the areas of specific Performance Measures and Performance Improvement indicators.
January 26, 2020
Maintains up-to-date knowledge of procedures and interpretations of all human resources, federal, state and CMS laws and regulations.
March 20, 2020
Participate in the planning, development, coordination, and presentation of specific training and educational programs as appropriate to the quality assurance needs of the facility or service.
March 30, 2020
Demonstrate and maintain current working knowledge of the required BCBSAZ systems, procedures, forms and manuals.
April 26, 2020
Review and assist Physician Reviewers in composing denial reasons to ensure the denial reason language is clear and concise and citing correct clinical criteria and utilizes the correct product specific grade level language.
April 29, 2020
Prepare for and participate in health plan audits, pre-audit documentation submissions and corrective action plans based on health plan audit findings with Compliance Manager as well as UM Manager.
May 04, 2020
Assists with quality improvement and practice transformation projects including but not limited to, workflow optimizations, medical record auditing, population health management, Patient Centered Medical Home (PCMH) recognition, data stewardship/governance.
May 13, 2020