Clinical Internal Audit Manager

DUTIES AND RESPONSIBILITIES:
1. In line with annual quality planning and functional goals, come outwith the individual internal audit programs.
2. Works with departments across Jiahui Health to ensure compliance withNational regulation and clinical evidence practice by establishinghospital and physician coding auditing program.
3. Manage day to day activities in Internal Audit guided by clinicalquality goal and auditing reference, such as clinical guidelines fromeach specialty, evidence-based medicine, and official coding guidelines,to identify risks, standard variation.
4. Coordinates with other qualified auditors or quality controller, togather and integrate information from various resources to provideintelligence on key trends and findings to enable inspection readiness activities.
5. Assure deviations are addressed in a timely manner and consistentwith good documentation practices and SOPs.
6. Drives the quality cycle from planning through to action, utilizingaudit to ensure ongoing compliance and intelligence gathering fortargeted continuous improvements
7. Evaluate and present solutions on complex issues independently fromsenior staff.
8. Participate in and deliver training to stakeholder groups.
9. Remaining abreast of current regulations and industry best practicesin clinical quality standard.

EXPERIENCES, SKILLS AND ABILITIES
 Expertise in clinical codes and practices, e.g. ICD-10-CM code sets,coding guidelines, clinical documentation integrity and treatmentprotocols, etc.
 Clinical Validation Skills. Demonstrate the ability to identify,apply, and validate the use of current industry standard clinicalindicators, risk factors and treatment protocols used in clinicalvalidation of payment impacting code assignment.
 Familiar with National standards and regulations, Knowledge andskillful implement quality improvement tools, e.g. PDCA, RCA, etc.
 Communicates clearly, proactively, and concisely with all keystakeholders.
 Actively seek out new ideas, possibilities, and answers to the toughquestions. Pays meticulous attention to detail, identifies aberrant codeassignment, mines medical records for all relevant and supporting evidence.
 Proactive and self-directed. Show initiative and responsibility intaking the necessary steps towards problem resolution.
 Proactively prioritizes initiatives, effectively manages resources andcan multi-task. Actively manages their work assignments
 Ability to work at a cross-culture and diverse organization.
 Education or experience:
 Prefer 6 years of experience in healthcare setting, minimum 3 yearexperience working in medical administration or Quality Compliance.
LICENSES/CERTIFICATIONS: Specify minimum credentials and clearlyindicate if required or preferred.