Quality Analyst (Minnesota Aging Pathways)

Quality Analyst (Minnesota Aging Pathways) Arrowhead Regional Development Commission Duluth, MN Job Details Full-time $28.50 - $32.50 an hour 9 hours ago Benefits Health savings account AD&D insurance Health insurance Dental insurance 401(k) Flexible spending account Paid time off Parental leave Loan forgiveness Life insurance Retirement plan Qualifications Collaborate with healthcare professionals TJC Medicare Coaching Medical billing compliance checks CMS regulatory compliance Driver's License Bachelor's degree Medicare regulations Attention to detail Healthcare privacy protection Centers for Medicare and Medicaid Services (CMS) Call monitoring Adaptability Human Services Social Work Clinical documentation standards Clinical data analysis Cross-functional communication Quality assurance within healthcare Performance evaluation Full Job Description Job Summary We are seeking a meticulous and dedicated full-time Quality Analyst to join our team focused on Minnesota Aging Pathways. This role involves ensuring the highest standards of compliance, accuracy, and quality in healthcare documentation, coding, and regulatory adherence within programs serving older adults. The ideal candidate will play a vital role in maintaining compliance with federal and state regulations, including Medicare, HIPAA, JCAHO standards, and FDA regulations, while supporting the integrity of clinical and administrative processes. This position offers an opportunity to contribute to meaningful initiatives that enhance the quality of care and service delivery for aging populations. Responsibilities Conduct comprehensive reviews of healthcare documentation to ensure adherence to HIPAA privacy standards and regulatory requirements. Verify proper utilization of CPT coding, ICD-9, ICD-10, and ICD coding systems for accurate billing and reporting. Ensure compliance with Medicare guidelines and other federal healthcare regulations. Monitor clinical records for accuracy and completeness in accordance with JCAHO accreditation standards. Collaborate with healthcare providers to identify areas for process improvement related to documentation quality and compliance management. Assist in audits related to FDA regulations and other applicable healthcare policies. Maintain detailed records of compliance activities, discrepancies, and corrective actions. Provide training and guidance on coding practices, regulatory updates, and compliance protocols. Support ongoing quality improvement initiatives by analyzing data trends and recommending enhancements. Required education, experience and

• skills: Ø A minimum of a
• Bachelor's degree from an accredited college or university in a human services-related field, such as social work, nursing, public administration, gerontology and two years of experience in quality assurance, performance management, data analysis, or operational leadership in a contact center, and experience evaluating calls, documentation, or case management activities and experience providing coaching and performance evaluation; OR Ø A •two-year certificate or degree in a human services-related field or a community health certificate and four years of experience as described above; OR Ø •Six-years of experience as described above.

A valid driver's license is also required. Strong knowledge of HIPAA regulations and privacy standards. Proficiency in CPT coding, ICD-9, ICD-10, and ICD coding systems. Familiarity with Medicare billing procedures and compliance requirements. Understanding of FDA regulations relevant to healthcare documentation. Experience with JCAHO accreditation standards and compliance management processes. Excellent analytical skills with attention to detail in reviewing complex documentation. Effective communication skills for collaborating across multidisciplinary teams. Ability to adapt quickly to regulatory changes and implement best practices. This position is integral to maintaining the integrity of healthcare services provided to aging populations while ensuring strict adherence to all relevant regulations. We invite qualified candidates committed to excellence in healthcare quality assurance to apply today.

Hours:

40 hours/week, M-F, day position.

Location:

Employees could be located in any of the seven NE MN Counties (Aitkin, Carlton, Cook, Itasca, Koochiching, Lake, St. Louis) or WI (Douglas County).

There are three work options:

work in the Duluth office, a hybrid model meaning partial work in the Duluth office and partial work from home, or fully remote. When working offsite, employees must meet specific internet criteria including demonstrated high speed connect ability and the ability to meet privacy and security standards with secure (password protected) internet and demonstrate successful performance.

Pay:

$28.50 - $32.50 per hour

Benefits:

401(k) AD&D insurance Dental insurance Flexible spending account Health insurance Health savings account Life insurance Loan forgiveness Paid time off Parental leave Retirement plan

Work Location:

Hybrid remote in Duluth, MN 55802