Director, Medical Records//Quality Assurance – Philadelphia County

Full Time
  • Post Date: January 2, 2019
  • Apply Before: March 28, 2019
  • Qualification MSW
Job Description

Responsible for the management of the Medical Records department and Quality Assurance Program.   Functions as HIPAA Privacy Officer in order to insure the confidentiality and privacy of consumer health information in accordance with HIPAA regulations.

Medical Records

Supervises medical records staff to assure adequate and efficient service to consumers and professional staff.  Maintains system to monitor quality and quantity of staff productivity.  Establishes, defines, documents, implements and maintains all procedures, methodologies and performance standards of the Medical Records function. Oversees the maintenance of medical records for all clients serviced by the organization including a system for coding, indexing, archiving and filing the medical records in accordance with standards established by regulatory and accrediting agencies. Accountable for meeting staffing needs of Medical Records Department to include employee selection, evaluation, and discipline.  Provides adequate number of staff whose qualifications are consistent with job responsibilities. Responsible for administrative oversight of the Carelogic electronic health records system.

Quality Assurance

  • Review case records to ensure proper utilization of treatment resources.
  • Review consumer records for proper case documentation and medical necessity of treatment in relation to federal, state, and county regulations.
  • Review consumer admission data, clinical documentation to ensure compliance for medical necessity and case documentation.
  • Assess records for appropriate treatment, after care and discharge planning.
  • Provide training and information about utilization requirements to clinical, supervisory and management staff in utilization and quality improvement meetings and projects.
  • Participate in audits of programs to ensure agency compliance on utilization review regulations.
  • In conjunction with program management, formulate and monitor action plans to remedy opportunities for improvement identified.
  • Coordinates CPR training and maintains appropriate records.
  • Establishes and maintains linkage agreements with appropriate agencies.
  • Completes surveys and census requests.

HIPPA Compliance

  • Maintains compliance with federal and state laws related to privacy, security, confidentiality, and protection of information resources.
  • Serves as a liaison to regulatory and accrediting bodies for matters relating to privacy and security.
  • Collaborates with other departments such as human resources, accounting, IT/IS, and clinical programs to ensure compliance with specific privacy, security, and electronic transaction requirements.
  • Monitors all departmental systems development and operations for privacy and security requirements.
  • Participates in the development, implementation, and ongoing compliance monitoring of all trading partner and business associate agreements to ensure all privacy concerns, requirements, and responsibilities are addressed.
  • Performs initial and periodic information privacy risk assessments and conducts related ongoing compliance monitoring activities.
  • Establishes with management and operation a mechanism to track access to protected health information as required by law and to allow qualified individuals to review or receive a report on such activity.
  • Coordinates with HR and other appropriate officers to develop appropriate sanctions for failure to comply with the corporate privacy policies and procedures by all members of the organization and/or business partners.
  • Maintains current knowledge of applicable Federal and state privacy laws and accreditation standards, and monitors advancements in information privacy technologies to ensure organizational adaptation and compliance.
  • Provides for educational programs periodically on HIPAA to Agency staff.
  • Works with HR, I/T, and management to develop appropriate policies and procedures related to Confidentiality, HIPAA privacy and security, and HIT regulations.

MSW and a minimum of five years of relevant experience, with at least two years managerial experience. Excellent verbal and written communication. Excellent organizational skills and interpersonal skills. Ability to meet deadlines and accomplish work in order of priority. Ability to negotiate conflict and maintain constructive working relationships with people at all levels of an organization.