Change Healthcare Clinical Validation Nurse Audit Manager in Lombard, Illinois
Transforming the future of healthcare isn’t something we take lightly. It takes teams of the best and the brightest, working together to make an impact.
As one of the largest healthcare technology companies in the U.S., we are a catalyst to accelerate the journey toward improved lives and healthier communities.Here at Change Healthcare, we’re using our influence to drive positive changes across the industry, and we want motivated and passionate people like you to help us continue to bring new and innovative ideas to life. If you’re ready to embrace your passion and do what you love with a company that’s committed to supporting your future, then you belong at Change Healthcare.
Pursue purpose. Champion innovation. Earn trust. Be agile. Include all.
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TitleClinical Validation Audit Manager- Registered Nurse (RN)
Overview of Position
The Clinical Validation Audit Manager will be responsible for overseeing a team of Clinical Validation Auditors. This position is responsible for claims assignment, quality assurance, and clinical and coding education for the Clinical Validation Auditors (CVA). The Clinical Audit Supervisor will interface with CVA staff, physicians, clients, and management as necessary to ensure audit accuracy and integrity in accordance with client contracts and clinical and coding guidelines.What will be my duties and responsibilities in this job?
• Oversight of a team of up to 15 CVA auditors
• Clinical and coding education for CVA auditors as needed during regularly scheduled team meetings.
• Act as a point of contact for account management and clients regarding Clinical Validation
• Oversight of periodic quality assurance reviews and documentation analysis of CVA audits to ensure consistency and accuracy in accordance with clinical guidelines, client expectations, and contractual requirements.
• Identify and review potential CVA audit inconsistencies, target areas of improvement, and communicate findings with management and audit staff.
• Demonstrate commitment to EquiClaim/Change Healthcare core values
• The position responsibilities outlined above are in no way to be construed as all encompassing. Other duties, responsibilities, and qualifications may be required and/or assigned as necessary.
What are the requirements needed for this position?
• Graduate of an accredited College or University with a current R.N. license
• Registered Health Information Technologist (RHIT) or Registered Health Information Administrator (RHIA), or equivalent coding certification
• 5+ year of diverse acute care clinical nursing experience
• 5+ years of clinical auditing experience
• 5+ years of coding experience including extensive knowledge of inpatient coding requirements and documented competency in both ICD-CM and PCS.
• Ability to perform in-depth analysis of clinical documentation relating to appropriateness of care and clinical coding
• Ability to use software, hardware, and peripherals related to job responsibilities, including MS Office
• Excellent oral and written communication skills
• Excellent analytical, organizational, and prioritization skills
• Ability to interface with all levels of the company including clients
• Ability to multi-task in a fast-paced environment
What other skills/experience would be helpful to have?
• Certified Documentation Improvement Practitioner (CDIP) or equivalent preferred
What are the working conditions and physical requirements of this job?
General office demands
How much should I expect to travel? Up to 10%
Employees in roles that require travel will need to be able to qualify for a company credit card or be able to use their own personal credit card for travel expenses and submit for reimbursement.
Join our team today where we are creating a better coordinated, increasingly collaborative, and more efficient healthcare system!
Equal Opportunity/Affirmative Action Statement
Change Healthcare is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, genetic information, national origin, disability, or veteran status. To read more about employment discrimination protections under federal law, read EEO is the Law at https://www.eeoc.gov/employers/eeo-law-poster and the supplemental information at https://www.dol.gov/ofccp/regs/compliance/posters/pdf/OFCCP_EEO_Supplement_Final_JRF_QA_508c.pdf.
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Change Healthcare maintains a drug free workplace and conducts pre-employment drug-testing, where applicable, in accordance with federal, state and local laws.
Change Healthcare is an equal opportunity employer. All qualified applicant will reveive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, genetic information, national origin, disability, or veteran status.
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