RN Clinical Quality Analyst - Hospice

Description

Job Summary:

The RN Clinical Quality Analyst supports clinical business decisions, operational processes, and internal process improvements initiatives to improve reliability of care and outcomes for the organization. This position will incorporate clinical best practices by interpreting data, producing both long term and short-term activities to drive measurable solutions. The RN Clinical Quality Analyst creates analytical tools using an in-depth understanding of healthcare data such as patient, claims, financial and provider data. Assists and/or leads peer reviews by preparing case summaries, data collection, and submission of clinical data to appropriate governing agencies. This position collaborates with the Interdisciplinary team to plan, identify, act, and evaluate the educational needs of the organization in relevance to the federal and state rules and regulations

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Accountability: Reports to the Director of Quality, Compliance & Education

FLSA Status: Exempt/Salary

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Requirements

Job Duties and Responsibilities:

Specific to Job Functions:

1. Maintains up to date knowledge of Federal and State hospice rules and regulations, LCD Guidelines, CHAP Standards of Excellence, Nevada Medicaid rules and regulations and CMS Conditions of Participation
2. Supports systems and policies as well as procedures for analysis of performance measurement data
3. Collects and analyzes data to identify trends, collaborating with the clinical teams on root cause analysis.
4. Assists with facility and interdisciplinary projects and audits (i.e., technical, and clinical audits)
5. Coordinates and/or leads action plans for improvement including follow up evaluation of data and organizational performance in meeting or exceeding quality benchmarks to ensure consistent improvement
6. Coordinates the completion of annual agency-wide systematic review and annual policy review
7. Gathers data from unusual occurrences and complaints and summarizes trending at designated time frames for reporting in line with regulatory requirements
8. Completes HIS/HOPE admission and discharges
9. Monitors and tracks hospice consents to ensure compliance
10. Assists and ensures compliance with live discharges
11. Supports action plans under the guidance of the Director of Quality, Compliance & Education for improvement including follow-up evaluation of data and organizational performance
12. Monitors and assists with cost reduction strategies for supply ordering
13. Collaborates educational opportunities and activities for the development of quality and regulatory educational programs
14. Reviews claims and ensures staff compliance in completing and closing out patient visits in a timely manner
15. Serves as a superuser of EHR system and assists with EHR quality and compliance education for clinical and non-clinical staff
16. Complies with all documentation policies/procedures and completes appropriate documentation in a legible and timely manner
17. Performs special projects as assigned by the Director of Quality and Compliance
18. Other duties as assigned

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Education and Training Functions:

1. Coordinates staff completion of BLS and ACLS certifications
2. Manages the equipment/tools and skills stations needed
3. Assists in coordination of clinical rotations and student orientation packet completion
4. Trains staff in new hire orientation (departmental) and assists in general facility orientation
5. Assists with staff training in QI certification and other required training
6. Coordinates preceptor program
7. Facilitates the implementation of all new competencies and equipment
8. Organizes, plans, and manages time effectively to complete assignments
9. Completes mandatory training and courses required by completion date
10. Ensures staff completes regulatory compliance orientation and refresher training
11. Provides education in compliance with federal, state, and regulatory agencies
12. Ensures training requirements and standards for CHAP and regulatory (federal and state) agencies are met

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Additional Functions:

1. Adheres to patient rights, abuse reporting, and confidentiality policies
2. Fosters and maintains an effective working relationship between peers, professional staff, and other personnel within the community
3. Understands the principles of palliative care/pain management within the Scope of Practice
4. Complies with all documentation policies and procedures
5. Completes appropriate documentation in a legible and timely manner
6. Attends scheduled staff meetings and in-service training
7. Adheres to the departmental dress code requirements related to personal grooming and attire
8. Participates in Performance Improvement activities as requested
9. Demonstrates reliability by providing proper notification for absence or tardiness, participating in required meetings
10. Demonstrates ability to problem-solve and make decisions by assessing situations and considering alternatives, seeking guidance and direction as necessary, utilizing proper chain of command
11. Demonstrates effective time management skills by coordinating activities to achieve maximum productivity and efficiency, willingness to adjust or revise work schedules as requested
12. Assumes responsibility for on-going personal development and continuing education.
13. Stays current with all mandatory agency and regulatory requirements
14. Completes assigned projects within specified time frames.
15. Reports questionable situations, concerns, complaints, or harassment immediately.

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Physical/Safety Requirements:

1. Participates appropriately in emergency procedures (including disaster drills)
2. Operates equipment in a safe manner and shares responsibility for communicating safety violations or unsafe practices to management
3. Used general office equipment as intended
4. Category 2 for potential exposure to blood/body fluids. (Does not usually require the performance of procedures or other tasks in the work routine that involve exposure to blood, body fluids, or tissues, but Category 2 tasks may require the unexpected performance of these procedures)
5. Utilizes appropriate PPE as needed
6. Must be able to move intermittently throughout the workday
7. Must have the strength and endurance required for sitting for lengthy periods of time
8. Must be able to lift 10-25 lbs.
9. Must possess sight, hearing, and speech senses, or use prosthetics that will enable these senses to function adequately so that the requirements of this position are fully met

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job.

In compliance with the Americans with Disabilities Act of 1990, the employer will provide reasonable accommodations to meet the work environmental and physical demands listed above.

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Qualifications and Experience:

1. Graduate of an accredited school of nursing with a minimum of a current LPN licensure in the State of Nevada; RN preferred
2. Must be CPR/BLS Certified
3. Must have at least 5 years clinical nursing experience
4. 3 years in a hospice quality role preferred
5. Must have experience working with hospice accrediting bodies
6. Must possess strong knowledge of Microsoft Office programs; Excel, Word, and PowerPoint required
7. Certification in CPHQ or Lean Six Sigma preferred or ability to obtain certification within specified time frame
8. Must be able to read, analyze, and interpret business periodicals, professional journals, technical procedures, state, and governmental regulations
9. Must have reliable transportation, a valid driver’s license and maintain current auto insurance
10. Successful completion of a background check pursuant to NRS 449.188 and NRS 179A.100 along with a pre-employment drug screen and physical, TB testing, previous employment and reference checking, and an MVR (may include verification of education)
11. Must read, speak, write, and understand the English language

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Benefits:

• Welcoming Culture
• Paid Time Off
• NV Paid Leave
• Medical Insurance
• Dental & Vision Insurance
• Voluntary Ancillary Insurance
• Paid Holidays
• Floating Holiday
• 401k with Company Match
• Employee Assistance Program
• Employee Discount Program
• Uniforms