Clinical Audit Manager

Ensure the clinical governance framework is being implemented& adhered to by all related staff at their assigned hospital.Ensure the implementation of the national legislative and mandatory quality improvement requirements as agreed& stated & demonstrate the data to management team.Develop reports of investigative findings and issue findings in accordance with applicable regulations, policies and procedures.Ensure that the assigned Hospital& inter-departments work collaboratively, internally and with partners, to identify priorities and approaches to quality improvement.Ensure there is a scheme of reporting that supports transparency and public accountability including information formally required by the Ministry of Health in the assigned hospital.Demonstrate ways of working that systematically improve the safety, effectiveness and person-centeredness of clinical care, practice.Ensure that any emerging concerns over the quality and safety of care or services are recognized rapidly and escalated to ensure corporate awareness – thereafter each concern is fully reviewed and appropriate improvement plans are established, monitored and communicated in their assigned hospital.Measure the identified & agreed key clinical quality and clinical outcome measures in the respective hospital.Analyze clinical risk information and alert the management team with rising trends and hotspots, suggesting viable options for reduction and/or correction.Provide guidance and support to medical team regarding implementation of policies& procedures and ensure effective systems for evaluation are developed.Review medical documentation and records from a clinical perspective for potential fraud, waste, abuse or malpractice and identify trends in health care provider behavior and billing patterns.Analyze existing clinical audit practices and policies to define and ultimately implement changes to improve clinical integrity and overall hospital’s processes.Conduct independent data mining and data analysis utilizing all available medical& claims data to identify areas or scopes for development & raise corrective or preventive actions as needed.