Clinical & Quality Auditor

**Hours**: 37.5 hours per week between Mon to Fri 09:00 to 17:30
**Status**: Full-time, permanent
**Salary**:£35,000 - £42,000
**Qualifications, Skills and Experience**: You must have significant musculoskeletal experience and be actively registered with the HCPC as a physiotherapist, occupational therapist, or with the NMC as a nurse.

**Background and purpose of the role**:
Health & Care Management Ltd. (HCML) is a rehabilitation company that works to coordinate and accelerate the rehabilitation of injured individuals. HCML’s Clinical and Support Services work within a comprehensive Clinical Governance framework, overseen by HCML’s Medical Director, to ensure that we are providing market leading excellence in clinical case management services to our patients/clients and customers. HCML now has a centralised clinical governance function, of which this role forms a key part.

Our Personal Injury case managers coordinate the rehabilitation of individuals who may have severe injuries such as spinal cord or acquired brain injuries; our Health team assesses private medical insurance claimants and routes them into appropriate treatment pathways to help accelerate their recovery, and our Corporate team works with employees to help rehabilitate and return injured employees to work. Our customers are insurers, solicitors and employers and we are responsible for delivering clinically and administratively excellent service.

The Clinical & Quality Auditor (CQA) will be responsible for auditing cases which include assessment reports, phone calls and more with the aim of directly supporting and supervising clinical staff to deliver an excellent and safe clinical administrative service. This will ensure all required administrative standards are met and data outputs are complete in a timely and accurate manner. The CQA will work closely with the Performance and Quality Management team (P&QM) Manager, the Customer Experience Manager, Business Analyst and the Business Information & Management Information (BI&MI) team to identify opportunities for process and system improvements that will help to optimise service delivery and/or reduce non-compliance with documented processes.

**Main job tasks and responsibilities**:
Clinical auditing
- Reviewing and auditing cases, documentation, phone calls and other areas of staff work. Reviewing clinical decisions, and that rehabilitation clients are being communicated with effectively to ensure that they are being appropriately supported in their recovery

Quality & process auditing
- Reviewing and auditing cases to ensure that all system users are adhering to correct policies and procedures in relation to timeliness and order of actions, note keeping, data capture and accuracy, documentation filing etc.
- Ensuring that all required outputs (e.g. data, correspondence etc.) is accurate and timely so that HCML is complying with our customers’ minimum requirements
- Supporting line managers to manage the performance of their teams against external and internal KPIs and advocating the expectations of a high-performance culture across HCML

Supplier auditing
- Auditing supplier reports, documentation and any other correspondence and information about the service that the clinical suppliers are delivering to review their clinical decisions making.
- Supporting HCML’s Supplier Manager to ensure high performance delivery against KPIs by our customers

Supervision, support, advice & training
- Offering active and passive support and advice to HCML staff on clinical questions, and also in relation to the audit findings Examples include, real-time clinical support, 1-2-1 feedback sessions with individual staff, briefing out audit findings in team huddles, or setting up “lunch and learn” sessions as part of HCML’s academy to educate HCML staff as to common issues and remedial actions

Root cause analysis
- Identifying the root causes behind non-compliance and working with the wider performance, operations, and support teams to eliminate these root causes and improve compliance and performance across the business

Report writing & action implementation
- Supporting the P&QM Manager to write informative reporting for the Operating Board and the company Board to show the level of non-compliance across the business and setting out remedial action plans to improve quality and performance
- Supporting the P&QM Manager and relevant line managers to implement and complete remedial actions plans

Identifying opportunities for change
- Working with HCML’s P&QM manager and Business Analyst to use findings from the audits performed by their team to identify efficiency gains and system and process improvements across the business to find the most efficient ways of working creating increased capacity to focus on accelerating the recovery of the rehabilitation clients in our care.

HCML policy integrity
- Work with owners of HCML policies (e.g. the incident management policy, clinical governan