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Clinical Auditor Home Healthcare Home Health QA LPN in Annandale, VA at Professional Health Care Resources

Date Posted: 4/28/2018

Job Snapshot

Job Description

Summary and Responsibilities:

The Clinical Auditor supports the organization’s mission to maintain compliance with all mandatory regulations and continuously improve the quality and service of care. The Clinical Auditor will conduct reviews of Personal Care clinical records for accuracy of compliance with District of Columbia state and waiver program requirements, Chap and Medicare Conditions of Participation, and compliance with evidence-based standards of care for the Personal Care agency located in Washington DC.   The Clinical Auditor’s primary function is to evaluate data, documents and resources to check performance against standards. It is essentially a process of fact finding and interpretation and, as such, provides an efficient tool for improvement of quality.

  1. Systematically reviews clinical documentation against an explicit set of criteria or standards.
  2. Uses the audit cycle of preparation and planning, measurement of performance, improvement in performance and maintenance of improvement as a basis of the audit function.
  3. During the auditing process monitors systems and identifies problem areas and reports these to the Administrators/ Clinical Managers both verbally and through written reports.
  4. Meets deadlines and productivity requirements
  5. Participates in the Corporate QAPI Advisory Team as requested.
  6. Assists in Performance Improvement Projects (PIPS) with the local agency.
  7. Reports problems to the Director of Education and assists her in educating staff on improvement activities when needed.
  8. Uses effective interpersonal relations and communication skills to achieve desired results
  9. Provides consistent delivery of quality customer service
  10. Demonstrates skill in diplomacy and conflict resolution
  11. Maintains confidentiality
  12. Shows ability to juggle multiple competing tasks and demands
  13. Completes special projects and other duties as assigned.
  14. Meets mandatory annual education requirements


  1. To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skills, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
  2. Acceptable health status, as defined in agency policy.

Education and/or Experience:

  • Currently licensed as a Registered Nurse in the District of Columbia
  • A minimum of two years’ experience in Personal Care in the District of Columbia
  • At least 2 years of clinical auditing experience required.
  • Extensive knowledge of district and state regulations, as well as Medicare Regulations for home health required.
  • Excellent interpersonal skills and ability to communicate effectively required
  • Proven decision-making skills required.
  • Skilled in Microsoft Office Suite to include Word, Power Point, Outlook and Excel.
  • Ability to read, analyze, and interpret, technical procedures, and governmental regulations
  • Ability to effectively present information and respond to questions from managers and company executives
  • Ability to define problems, collect data, establish facts, and draw valid conclusions
  • Ability to manipulate and analyze data and present information in a concise, informative, format.