Quality Assurance - Performance Improvement Nurse

Job Summary

The Quality Assessment / Performance Improvement Nurse is a key member of the Home Health Administrative Team responsible for monitoring services and care delivered to patients of Frederick Health Home Care. Duties include reviewing and compiling Home Health Certifications/Plans of Care for appropriateness and compliance, conducting comprehensive chart audits, analyzing data, identifying potential performance improvement projects (PIPs), assisting in their implementation, and educating staff.

Essential Job Functions / Responsibilities

• Reviews OASIS documentation and works with Clinical Staff as needed to incorporate any recommended changes.
• Codifies and coordinates with coding vendor to assure coding work is being done timely.
• Reviews and generates a compliant Comprehensive Plan of Care document for provider signature.
• Consults with appropriate clinical staff to clarify any data integrity issues and works with clinicians to make appropriate corrections per organization policy.
• Understands and promotes principles of continuous QAPI.
• Aids in the orientation of new staff to Home Health QAPI program.
• Participates in Quality Improvement and Corporate Compliance activities as assigned.
• Aids in the preparation and implementation of policies and procedures which meet Medicare, Medicaid, accreditation standards and state and local laws.
• Aids in survey readiness activities such as mock audits, training, and the development of corrective actions plans.
• Advises the leadership regarding the clinical compliance needs/ concerns of each program.
• Conducts the ongoing evaluation and interpretation of quality standards and accreditation standards to ensure compliance through reporting and measurement studies/ methodologies.
• Aids in developing plan of correction to survey deficiencies. Subsequently monitors program execution of plans of correction.

Required Knowledge, Skills And Abilities

• Education: Bachelors of Science Degree in Nursing or bachelor’s degree in health care administration or equivalent with knowledge, skills and abilities to perform the duties.
• Experience: Three to five years of home health experience required.
• Licensure: Currently licensed as a Registered Nurse in the State of Maryland or compact state.
• Special Attributes: Self-directed individual with calm demeanor, detail oriented with exceptional written and verbal communication skills. Well organized, with strong abilities to manage strict time constraints, set priorities, deliver high accuracy work and problem solve with minimal supervision. Sound leadership skills with exceptional comprehension of Home Health regulations, reimbursement criteria and performance indicators. Display impeccable integrity and ability to adhere to strict HIPAA guidelines to insure confidentiality of records of personnel, patients, reimbursement and performance improvement data. Knowledge of Home Health OASIS, Care planning and 485s, and regulatory requirements are required. Certification in OASIS and/or coding is strongly preferred.
• Attributes: Valid driver's license, reliable transportation, and current car insurance. Patient Contact Skills.

Reporting Relationship

Reports to Director of Home Care Operations

Caring for you as you care for the CommUNITY

Frederick Health offers a comprehensive and affordable benefits package including:

• Health, Dental and Vision insurance are offered the 1st of the month after 30 days of employment to all employees hired to work at least 20 hours per week and we offer multiple plans to best meet your and your family's needs.
• Life insurance, Short-Term Income Replacement and Long-Term Disability are employer paid for eligible employees.
• Fredrick Health offers a robust Paid Time Off program for eligible employees.
• We also offer an educational assistance program to support your education goals as well as an employer paid Employee Assistance Program.

Pay

Pay is based on experience, skills and education. If position is part-time, salary will be pro-rated based on scheduled hours. The pay range may also vary within the stated range based on specialty if applicable. Non-Exempt positions may have shift differential and/or Overtime paid, if applicable. Hourly range: $77,145 - $112,548