
Intermountain Health
Rn trainer auditor prn
Review medical records for HEDIS audits, abstracting relevant clinical information using a proprietary tool. Perform remote medical record reviews, ensuring compliance with HEDIS, CMS, and STARS measures.

Ascenti Physio
·2 days agoAscenti Physio
·2 days agoLocation
remote (anywhere)
Commitment
Full Time
Level
Lead / Manager
As a member of our esteemed Clinical Excellence Team, you will play a vital role in upholding the efficacy, safety, and overall quality of our patient-centered, technology-enabled physiotherapy services. Specifically, in the capacity of Clinical Quality & Audit Lead, you will leverage your extensive clinical expertise, ideally in Musculoskeletal (MSK) Physiotherapy, to become a senior contributor to our Clinical Excellence directorate.
In this influential position, you'll take charge of robust oversight, proactive leadership, and rigorous validation to ensure clinical excellence, maintain high-quality standards, and drive continuous improvement initiatives. Your role is characterized by its data-centric and analytical nature, emphasizing the meticulous execution of quality assurance protocols, comprehensive auditing, and focused improvement activities.
Your responsibilities span a wide spectrum, including the evaluation of patient experience metrics, treatment effectiveness, clinical outcomes, pathway compliance, legislative adherence, risk assessment, and audit protocols. Your contributions will be integral in preserving our commitment to delivering outstanding patient care and advancing the field of physiotherapy.
Auditing is a key aspect of this role, where you'll conduct thorough clinical audits across various service lines, identifying areas for improvement and best practices. Data analytics will be your ally, enabling you to evaluate incidents, enhance patient safety, optimize patient experiences, and measure outcomes effectively.
Collaboration is integral, and you'll work closely with our Clinical Development, Clinical Governance, and Digital Teams, fostering a culture of excellence throughout the organisation. Additionally, you'll establish robust systems for the early detection of quality issues and risk factors, ensuring that our services continually improve.
Your role will also involve generating regular reports that provide valuable insights for our internal leadership and enhance transparency and trust with our external customers.
In this data-centric and analytical position, you will drive the quality, safety, and effectiveness of our patient-centered, tech-enabled physiotherapy services. With a focus on Musculoskeletal (MSK) Physiotherapy, you'll become a cornerstone in upholding the clinical excellence that defines us.
Your responsibilities encompass strategic leadership, where you'll spearhead our clinical audit, quality agenda, and continuous improvement efforts, ensuring that we consistently deliver the highest standards of care. You'll innovate by developing and implementing comprehensive quality frameworks and methodologies that set the bar for excellence in patient care.
You will benefit from a competitive salary, 25 days of annual leave (+ bank holidays) and a great loyalty-based benefits package, which includes Vitality at Work membership, enhanced family (mat & pat) leave, free and discounted healthcare services and many other perks and rewards.
Ascenti is committed to continuous learning and progression, meaning that there will also be ample support and coaching in your role, with opportunities for you to develop if you wish. The goal is for Ascenti to be a workplace that creates a sense of belonging for everyone. This means that they actively work to promote equal opportunities across all that they do, including when recruiting new talent.
If you're passionate about driving clinical excellence and dedicated to improving patient care, we invite you to apply for the role of Clinical Quality & Audit Lead. Join us in making a difference in the lives of our patients and contributing to the future of physiotherapy.
As part of our Safer Recruitment procedures, this role will require a criminal reference check.
HCPC registered Physiotherapist
Extensive experience in a clinical role, preferably in Musculoskeletal (MSK) Physiotherapy (Minimum 4 years post-graduate musculoskeletal physiotherapy practice experience; preferably in both public and private settings).
Experience in conducting clinical audits and implementing quality assurance systems.
Demonstrated experience in stakeholder management.
Proven track record in leading projects to successful completion.
Following application review and an initial screening stage, shortlisted candidates will be invited to complete a short assessment before interview.
The assessment is designed to understand your experience of using data to identify issues or opportunities, deliver improvement initiatives, and measure outcomes.
Candidates will be asked to provide a real-world example from their professional experience, outlining how they analysed data, implemented change, engaged stakeholders, and evaluated the impact of their actions.
This exercise helps us understand your approach to data-driven decision making, continuous improvement, and delivering measurable results.
Please note: this is a fixed-term position until October - December 2027.

Intermountain Health
Review medical records for HEDIS audits, abstracting relevant clinical information using a proprietary tool. Perform remote medical record reviews, ensuring compliance with HEDIS, CMS, and STARS measures.

Blue Cross Blue Shield of Massachusetts
Lead a team of DRG validation auditors performing clinical validation and DRG reviews. Oversee pre-payment and post-payment audits, ensuring accuracy in claims reimbursement and compliance with coding guidelines.

UnitedHealth Group
Coordinate the Recovery Audit Contractor (RAC) audit program, ensuring compliance with regulations. Collaborate with various departments to manage audit planning, scheduling, and reporting. Analyze audit findings to identify trends and implement process improvements.

Health Care Service Corporation
Conduct audits and monitor quality improvement activities within the medical management program. Analyze compliance with policies and regulatory requirements, and prepare reports for management. Serve as a resource on quality and utilization issues and contribute to accreditation survey processes.

Yale New Haven Health
Educate providers and coding staff on CPT, ICD-10, and HCPC coding. Develop and maintain coding education programs, including training materials and curriculum. Conduct audits to assess risk and implement action plans based on findings.

Cook Children's Health Care System
Conduct coding quality reviews for inpatient and outpatient services, ensuring compliance with ICD-10-CM/PCS and CPT-4 guidelines. Develop and implement coding education and training programs based on audit findings and regulatory updates.

Gainwell Technologies LLC
Coordinate and perform appeal-related duties, including analyzing and responding to provider appeals. Review documentation to ensure all aspects of the appeal are addressed accurately. Prepare case files and summaries for hearings, and participate in virtual and on-site hearings.