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Somatus Coordinator, Auditor/Risk in Santa Fe, New Mexico

Coordinator, Auditor/Risk at Somatus

Remote

Summary:

The Coordinator Audit Risk will be responsible for coordinating and implementing the quality management and quality improvement programs for data collection and analysis of complaints, grievances, variances, incidents, and patient surveys. This individual will be responsible for creating and analyzing reports for the quality leadership team and regulatory specialists.

Essential Duties and Responsibilities:

  • Assists quality management team and regulatory specialists to plan, design, implement, and maintain a comprehensive clinical practice continuous quality improvement program including audit and risk management

  • Identify and monitor organizational efforts to ensure compliance with internal and external regulatory standards

  • Coordinate the effort to gather data and prepare reports to meet the requirements of NCQA and other regulatory/accrediting agencies, including health plans, providers, patient satisfaction, complaints, and grievances.

  • Assist with evaluating variance and other data to identify QI opportunities and risk management issues

  • Meets with internal and external audiences to identify and problem-solve QI issues

  • Facilitate and lead project meetings, documenting summaries and communicating next steps

  • Assist with the analysis, design, development, implementation, and evaluation of RCA, variance, and incidents, etc.

  • Adhere to established timeframes for audit deliverables in partnership with Quality leadership

  • Report findings to other departments such as population health, training, and quality leadership team

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.

Required Education and Experience:

  • Bachelor's degree, Nursing degree, or other comparable healthcare experience

  • One (1) year experience supporting organizational quality activities including but not limited to CQI principles, audits, complaints and grievances, and patient satisfaction reports

  • Licensed Practical Nurse (LPN) and/or Licensed Vocational Nurse (LVN) or higher

Knowledge, Skills, and Abilities:

  • Knowledge of CQI principles, practices, methods, and tools

  • Ability to analyze QI data and identify trends and corrective actions

  • Skill in conducting QI checks of medical records and other clinical documentation and performing patient satisfaction surveys

  • Ability to manage multiple, competing priorities within quick deadlines

  • Ability to be both a strategic and tactical change agent in the healthcare space

  • Strategic solution-seeker who sees opportunities when others see barriers

  • Strong interpersonal skills and ability to communicate effectively

  • Ability to handle ambiguity, including applying critical thinking and execute with minimal direction

  • Proficient in all Microsoft Office products including (but not limited to) Word, Excel, PowerPoint, SharePoint, OneDrive, and Outlook

Travel Requirement:

  • This position may require up to 10 - 25% travel. Travel may be outside the local area and overnight.

Physical Requirements:

  • This job operates in a professional setting. While performing the duties of this job, the employee is regularly required to sit or stand for extended periods of time. Normal manual dexterity is required.

  • Normal speaking and hearing abilities to interact with others in an office environment, over telephone or other video conferencing platform.

  • The employee is occasionally required to stand; walk; and reach with hands and arms and continuously repeat the same hand, arm finger motion many times as in typing.

Other Duties:

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.

Our priority is the health and safety of our members, colleagues, partners, and community. Proof of COVID-19 Vaccination is required for employment. If you are unable to be vaccinated for medical reasons or sincerely-held religious beliefs, we will consider requests for reasonable accommodations consistent with our policy, and where we are able to provide such accommodations without undue hardship to the company pursuant to applicable law.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions .

Somatus, Inc. provides equal employment opportunity to all individuals regardless of their race, color, creed, religion, gender, age, sexual orientation, national origin, disability, veteran status, or any other characteristic protected by state, federal, or local law. Further, the company takes affirmative action to ensure that applicants are employed, and employees are treated during employment without regard to any of these characteristics. Discrimination of any type will not be tolerated.

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